| Titre : | Education and incident Alzheimer's disease : a biased association due to selective attrition and use of a two-step diagnostic procedure ? (1999) |
| Auteurs : | M.I. GEERLINGS ; L.M. BOUTER ; C. JONKER ; J. LINDEBOOM ; B. SCHMAND ; Institute for Research in Extramural Medicine Emgo Institute Vrije Universiteit. Amsterdam. USA |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 28, n° 3, 1999) |
| Pagination : | 492-497 |
| Langues: | Anglais |
| Mots-clés : | Démence Alzheimer ; Niveau enseignement ; Epidémiologie ; Incidence ; Facteur risque ; Personne âgée ; Homme ; Europe ; Système nerveux [pathologie] ; Pays Bas |
| Résumé : | [BDSP. Notice produite par INIST aXzR0xi8. Diffusion soumise à autorisation]. Background It is still not clear whether a low level of education increases the risk of developing Alzheimer's disease (AD). Two common problems in cohort studies involving an elderly population and a two-step diagnostic procedure are the loss to follow-up without data on the presence of AD, and the fact that, in general, people with higher levels of education perform better on traditional cognitive tests, such as the Mini-Mental State Examination (MMSE). Both phenomena may lead to misclassification, resulting in a biased association between level of education and AD. This study investigated to what extent these selection mechanisms may influence this association. Methods In the community-based Amsterdam Study of the Elderly (AMSTEL) a cohort at risk for AD was selected of 3778 people aged 65-84 years. Level of education was expressed in two categories : low (primary education or less) versus high (partial secondary education to completed university education). At follow-up, a sub-sample of elderly people was selected for further diagnostic evaluation, using a memory test in addition to the MMSE. Clinical diagnoses of AD were made according to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria. To examine the extent to which loss to follow-up may have affected the results, a sensitivity analysis was performed comparing two extreme possibilities. (...) |
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