Education and the association between vascular risk factors and cognitive function: a cross-sectional study in older Koreans with cognitive impairment.
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.


CONCLUSIONS
The association between risk factors for cerebrovascular disease and cognitive impairment appears to be particularly strong in people with lower educational attainment.
Stewart
Robert
R
Section of Epidemiology, Institute of Psychiatry, London, UK. r.stewart@iop.kcl.ac.uk
Kim
Jae-Min
JM
Shin
Il-Seon
IS
Yoon
Jin-Sang
JS
D000368:Aged; D020144:Basal Ganglia Cerebrovascular Disease / Q000208:ethnology / Q000209:etiology*; D003072:Cognition Disorders / Q000208:ethnology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000209:etiology; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007723:Korea; D008297:Male; D012307:Risk Factors