|Title||Instrumental variable approaches to identifying the causal effect of educational attainment on dementia risk.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Nguyen, TT, Tchetgen Tchetgen, EJ, Kawachi, I, Gilman, SE, Walter, S, Liu, SY, Manly, JJ, M. Glymour, M|
|Date Published||2016 Jan|
|Keywords||Aged, Aged, 80 and over, Dementia, Education, Nonprofessional, Educational Status, Female, Genetic Predisposition to Disease, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Polymorphism, Single Nucleotide, Protective factors, Risk Factors, Schools, United States|
PURPOSE: Education is an established correlate of cognitive status in older adulthood, but whether expanding educational opportunities would improve cognitive functioning remains unclear given limitations of prior studies for causal inference. Therefore, we conducted instrumental variable (IV) analyses of the association between education and dementia risk, using for the first time in this area, genetic variants as instruments as well as state-level school policies.
METHODS: IV analyses in the Health and Retirement Study cohort (1998-2010) used two sets of instruments: (1) a genetic risk score constructed from three single-nucleotide polymorphisms (SNPs; n = 7981); and (2) compulsory schooling laws (CSLs) and state school characteristics (term length, student teacher ratios, and expenditures; n = 10,955).
RESULTS: Using the genetic risk score as an IV, there was a 1.1% reduction in dementia risk per year of schooling (95% confidence interval, -2.4 to 0.02). Leveraging compulsory schooling laws and state school characteristics as IVs, there was a substantially larger protective effect (-9.5%; 95% confidence interval, -14.8 to -4.2). Analyses evaluating the plausibility of the IV assumptions indicated estimates derived from analyses relying on CSLs provide the best estimates of the causal effect of education.
CONCLUSIONS: IV analyses suggest education is protective against risk of dementia in older adulthood.
Times Cited: 0 0
|User Guide Notes|
|Endnote Keywords|| |
Cognitive status/Genetic analysis/Dementia/EDUCATION
|Endnote ID|| |
|Alternate Journal||Ann Epidemiol|
|PubMed Central ID||PMC4688127|
|Grant List||R01 ES020337 / ES / NIEHS NIH HHS / United States |
R21 AI113251 / AI / NIAID NIH HHS / United States
/ / Intramural NIH HHS / United States
ES020337 / ES / NIEHS NIH HHS / United States
R01 AI104459 / AI / NIAID NIH HHS / United States
AI113251 / AI / NIAID NIH HHS / United States