Low education and childhood rural residence: risk for Alzheimer's disease in African Americans.
OBJECTIVE
To examine the relationship between level of education and childhood rural residence as possible risk factors for AD in African Americans in Indianapolis.


BACKGROUND
Low level of education has been a risk factor for AD in some studies, but childhood rural residence has not been addressed in most of these studies.


METHODS
A two-stage community-based prevalence study of AD was conducted in a random sample of 2,212 African Americans > or =65 years of age. A subsample of clinically assessed normal individuals (180) and individuals diagnosed with AD (43) were compared on the variables of rural/urban residence in childhood and low (< or =6 years) or high (> or =7 years) education. A logistic regression model was used with interaction between rural residence and low education to estimate odds ratios for the two risk factors combined, adjusting for age and gender.


RESULTS
Odds ratios for AD: 6.5 (95% CI: 2.6 to 16.7) low education/rural residence; 0.5 (95% CI: 0.1 to 2.9) low education/urban residence; 1.5 (95% CI: 0.4 to 5.2) high education/rural residence, comparing with the group of high education/urban residence.


CONCLUSIONS
Childhood rural residence, combined with < or =6 years of school, was associated with an increased risk of AD in this sample. It is possible that low education by itself is not a major risk factor for AD, but, rather, is a marker for other accompanying deleterious socioeconomic or environmental influences in childhood.
Hall
K S
KS
Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202-5111, USA. khall@iupui.edu
Gao
S
S
Unverzagt
F W
FW
Hendrie
H C
HC
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D004493:Education; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population