title: School attainment in childhood is an independent risk factor of dementia in late life: results from a Brazilian sample.
abstract: BACKGROUND
  This study sought to assess whether lower school performance in childhood is a risk factor for dementia in old age.
  
  
  METHODS
  Participants aged 60 years or more (n = 111) with documented proof from schools were included. Grades in three subjects - Portuguese, mathematics, and geography - were recorded and the mean final grade in all disciplines were assessed. Dementia was diagnosed using DSM-IV criteria. Sociodemographic data, school performance, and years of education were ascertained by checking documents issued by schools. Health status (hypertension and diabetes) were self reported. Regression models were used to assess the role of school performance and years of education on the risk of dementia.
  
  
  RESULTS
  Dementia was diagnosed in 22 subjects. Higher school performance and years of education decreased the chance of dementia by 79% (OR = 0.21; CI 0.08-0.58) and 21% (OR = 0.79; CI 0.69-0.91), respectively. After adjustments for sociodemographic and clinical variables, only school performance remained statistically significant (OR = 0.06; CI 0.01-0.71).
  
  
  CONCLUSIONS
  Education in early life should be viewed as a health issue over the life course. School attainment in certain basic disciplines may be important for cognitive reserve and prevention of dementia in the elderly.
authors.affiliation: Centre for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
authors.forename: Ana Beatriz Costa
authors.initials: AB
authors.lastname: Bezerra
authors.forename: Evandro Silva Freire
authors.initials: ES
authors.lastname: Coutinho
authors.forename: Maria Lage
authors.initials: ML
authors.lastname: Barca
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
authors.forename: Eliasz
authors.initials: E
authors.lastname: Engelhardt
authors.forename: Jerson
authors.initials: J
authors.lastname: Laks
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D003704:Dementia / Q000453:epidemiology / Q000209:etiology*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D016017:Odds Ratio; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric