Lyketsos C G, Chen L S, Anthony J C
Department of Psychiatry and Behavioral Sciences, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Am J Psychiatry. 1999 Jan;156(1):58-65. doi: 10.1176/ajp.156.1.58.
The epidemiology of cognitive decline over 11.5 years was investigated in a large community-residing population, with a special emphasis on the relationship between education and cognitive decline.
The study was an 11.5-year follow-up of a probability sample of the adult household residents of east Baltimore. From the Baltimore cohort of the Epidemiologic Catchment Area study, 1,488 participants completed the Mini-Mental State during three study waves in 1981, 1982, and 1993-1996. For each study participant, the difference in scores on the Mini-Mental State between waves 2 and 3 was calculated.
Over a median interval of 11.5 years, the study participants' scores on the Mini-Mental State declined a mean of 1.41 points, and the scores of 68% of the participants declined by at least 1 Mini-Mental State point. With and without adjustment for age, greater declines were associated with having 8 years or less of formal education and with being African American.
Over a long time period, cognitive decline occurred in all age groups. Having more than 8 years of formal education was associated with less decline. However, beyond 9 years, additional education was not associated with a further reduction in cognitive decline. This suggests that a minimal amount of education during early critical periods might confer protection against cognitive decline later in life.
在一个大型社区居住人群中调查11.5年间认知功能衰退的流行病学情况，特别关注教育与认知功能衰退之间的关系。
该研究是对东巴尔的摩成年家庭居民概率样本进行的11.5年随访。从流行病学集水区研究的巴尔的摩队列中，1488名参与者在1981年、1982年以及1993 - 1996年的三次研究浪潮中完成了简易精神状态检查。对于每位研究参与者，计算第2次和第3次检查时简易精神状态检查得分的差异。
在中位间隔11.5年期间，研究参与者的简易精神状态检查得分平均下降了1.41分，68%的参与者得分至少下降了1个简易精神状态检查分值。无论是否对年龄进行调整，受正规教育8年或更少以及非裔美国人的认知功能衰退更为明显。
在很长一段时间内，所有年龄组均出现认知功能衰退。接受超过8年正规教育与衰退较少相关。然而，超过9年后，额外的教育与认知功能衰退的进一步减少无关。这表明在早期关键时期接受最低限度的教育可能会为晚年预防认知功能衰退提供保护。
