Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies

Annie  Robitaille; Ardo Van Den Hout; Robson J M Machado; David A Bennett; Iva Čukić; Ian J Deary; Scott M. Hofer; Emiel O Hoogendijk; Martijn Huisman; Boo Johansson; Andriy V Koval; Maaike van der Noordt; Andrea M.  Piccinin; Judith J M Rijnhart; Archana Singh-Manoux; Johan Skoog; Ingmar Skoog; John Starr; Lisa Vermunt; Sean  Clouston; Graciela Muniz Terrera

doi:10.1016/j.jalz.2017.10.003

Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies

Annie Robitaille, Ardo Van Den Hout, Robson J M Machado, David A Bennett, Iva Čukić, Ian J Deary, Scott M. Hofer, Emiel O Hoogendijk, Martijn Huisman, Boo Johansson, Andriy V Koval, Maaike van der Noordt, Andrea M. Piccinin, Judith J M Rijnhart, Archana Singh-Manoux, Johan Skoog, Ingmar Skoog, John Starr, Lisa Vermunt, Sean CloustonGraciela Muniz Terrera

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death.

Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated.

Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies.

Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.

Original language	English
Pages (from-to)	462-472
Number of pages	11
Journal	Alzheimer's & Dementia: The Journal of the Alzheimer's Association
Volume	14
Issue number	4
Early online date	1 Feb 2018
DOIs	https://doi.org/10.1016/j.jalz.2017.10.003
Publication status	E-pub ahead of print - 1 Feb 2018

Keywords / Materials (for Non-textual outputs)

cognition
dementia
life expectancy
education
socioeconomic status
multistate modeling

Access to Document

10.1016/j.jalz.2017.10.003Licence: All Rights Reserved

RobitailleEtalAD2018TransitionsAcrossCognitiveStatesAccepted author manuscript, 440 KBLicence: Creative Commons: Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND)

RA2661 Centre for Cognitive Ageing and Cognitive Epidemiology Phase 2. Main Budget.
Deary, I., Gale, C., Holmes, M., Logie, P., Maclullich, A., Porteous, D., Seckl, J., Starr, J., Wardlaw, J. & Okely, J.
1/09/13 → 31/08/19
Project: Research
Linking the Scottish mental surveys of 1947 to health records
Booth, T., Calvin, C., Deary, I., Dykiert, D., Parra, M. & Tieges, Z.
MRC
1/06/12 → 30/09/13
Project: Research
A Hundred at Ninety: the common cause Hypothesis of Ageing tested in four waves of the Lothian Birth Cohort 1921
Deary, I., Bates, T., Gow, A. & Starr, J.
UK central government bodies/local authorities, health and hospital authorities
1/01/11 → 31/12/12
Project: Research

Graciela Muniz Terrera
- Deanery of Clinical Sciences - Personal Chair of Aging, Health and Methods
- Centre for Clinical Brain Sciences
- Edinburgh Neuroscience
Person: Academic: Research Active

Cite this

Robitaille, A., Van Den Hout, A., Machado, R. J. M., Bennett, D. A., Čukić, I., Deary, I. J., Hofer, S. M., Hoogendijk, E. O., Huisman, M., Johansson, B., Koval, A. V., van der Noordt, M., Piccinin, A. M., Rijnhart, J. J. M., Singh-Manoux, A., Skoog, J., Skoog, I., Starr, J., Vermunt, L., ... Muniz Terrera, G. (2018). Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 14(4), 462-472. https://doi.org/10.1016/j.jalz.2017.10.003

@article{dd2643a0c613466c918f80afb92c2252,

title = "Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies",

abstract = "Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death.Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated.Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies.Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.",

keywords = "cognition, dementia, life expectancy, education, socioeconomic status, multistate modeling",

author = "Annie Robitaille and {Van Den Hout}, Ardo and Machado, {Robson J M} and Bennett, {David A} and Iva {\v C}uki{\'c} and Deary, {Ian J} and Hofer, {Scott M.} and Hoogendijk, {Emiel O} and Martijn Huisman and Boo Johansson and Koval, {Andriy V} and {van der Noordt}, Maaike and Piccinin, {Andrea M.} and Rijnhart, {Judith J M} and Archana Singh-Manoux and Johan Skoog and Ingmar Skoog and John Starr and Lisa Vermunt and Sean Clouston and {Muniz Terrera}, Graciela",

year = "2018",

month = feb,

day = "1",

doi = "10.1016/j.jalz.2017.10.003",

language = "English",

volume = "14",

pages = "462--472",

journal = "Alzheimer's & Dementia: The Journal of the Alzheimer's Association",

issn = "1552-5260",

publisher = "Wiley",

number = "4",

}

Robitaille, A, Van Den Hout, A, Machado, RJM, Bennett, DA, Čukić, I, Deary, IJ, Hofer, SM, Hoogendijk, EO, Huisman, M, Johansson, B, Koval, AV, van der Noordt, M, Piccinin, AM, Rijnhart, JJM, Singh-Manoux, A, Skoog, J, Skoog, I, Starr, J, Vermunt, L, Clouston, S & Muniz Terrera, G 2018, 'Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies', Alzheimer's & Dementia: The Journal of the Alzheimer's Association, vol. 14, no. 4, pp. 462-472. https://doi.org/10.1016/j.jalz.2017.10.003

Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies. / Robitaille, Annie ; Van Den Hout, Ardo; Machado, Robson J M et al.
In: Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Vol. 14, No. 4, 01.02.2018, p. 462-472.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Transitions across cognitive states and death among older adults in relation to education

T2 - A multistate survival model using data from six longitudinal studies

AU - Robitaille, Annie

AU - Van Den Hout, Ardo

AU - Machado, Robson J M

AU - Bennett, David A

AU - Čukić, Iva

AU - Deary, Ian J

AU - Hofer, Scott M.

AU - Hoogendijk, Emiel O

AU - Huisman, Martijn

AU - Johansson, Boo

AU - Koval, Andriy V

AU - van der Noordt, Maaike

AU - Piccinin, Andrea M.

AU - Rijnhart, Judith J M

AU - Singh-Manoux, Archana

AU - Skoog, Johan

AU - Skoog, Ingmar

AU - Starr, John

AU - Vermunt, Lisa

AU - Clouston, Sean

AU - Muniz Terrera, Graciela

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death.Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated.Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies.Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.

AB - Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death.Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated.Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies.Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.

KW - cognition

KW - dementia

KW - life expectancy

KW - education

KW - socioeconomic status

KW - multistate modeling

U2 - 10.1016/j.jalz.2017.10.003

DO - 10.1016/j.jalz.2017.10.003

M3 - Article

C2 - 29396108

SN - 1552-5260

VL - 14

SP - 462

EP - 472

JO - Alzheimer's & Dementia: The Journal of the Alzheimer's Association

JF - Alzheimer's & Dementia: The Journal of the Alzheimer's Association

IS - 4

ER -

Robitaille A, Van Den Hout A, Machado RJM, Bennett DA, Čukić I, Deary IJ et al. Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies. Alzheimer's & Dementia: The Journal of the Alzheimer's Association. 2018 Feb 1;14(4):462-472. Epub 2018 Feb 1. doi: 10.1016/j.jalz.2017.10.003

Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

Access to Document

Fingerprint

Projects

RA2661 Centre for Cognitive Ageing and Cognitive Epidemiology Phase 2. Main Budget.

Linking the Scottish mental surveys of 1947 to health records

A Hundred at Ninety: the common cause Hypothesis of Ageing tested in four waves of the Lothian Birth Cohort 1921

Profiles

Graciela Muniz Terrera

Cite this