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Education and the association between vascular risk factors and cognitive function: a cross-sectional study in older
Robert Stewart1, Jae-Min Kim, Il-Seon Shin
1Section of Epidemiology, Institute of Psychiatry, London, UK. r.stewart@iop.kcl.ac.uk
Background/Objective:
The association between hypertension, diabetes, and worse cognitive function has been reported to be stronger in groups with low levels of education. Using data from a cross-sectional community survey of Korean elders, we sought to investigate this within a sample with relative cognitive impairment.
Methods:
The sample consisted of 341 participants with Mini-Mental State Examination (MMSE) (Korean version) scores of 24/30 or below. Previous diagnoses were ascertained and participants were examined for resting blood pressure and nonfasting blood glucose and cholesterol.
Results:
After adjustment for age, occupation, physical dependence, and cholesterol levels, worse cognitive function (MMSE score <21) within the sample was associated with raised systolic blood pressure, raised glucose levels, and a previous diagnosis of diabetes. These associations were significant only in participants with no formal education. In this group the adjusted odds ratios for worse cognitive function were 1.18 (95% confidence interval [CI] 1.04-1.34) for each 10 mmHg increase in systolic blood pressure and 3.47 (1.14-10.6) for a previous diagnosis of diabetes. Odds ratios for the group with previous education were 0.99 (0.81-1.21) and 1.82 (0.48-6.92), respectively.
Conclusion:
The association between risk factors for cerebrovascular disease and cognitive impairment appears to be particularly strong in people with lower educational attainment.