Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

December 10, 2019; 93 (24) Article

Illiteracy, dementia risk, and cognitive trajectories among older adults with low education

View ORCID ProfileMiguel Arce Rentería, View ORCID ProfileJet M.J. Vonk, Gloria Felix, Justina F. Avila, Laura B. Zahodne, Elizabeth Dalchand, View ORCID ProfileKirsten M. Frazer, Michelle N. Martinez, Heather L. Shouel, View ORCID ProfileJennifer J. Manly
First published November 13, 2019, DOI: https://doi.org/10.1212/WNL.0000000000008587
Miguel Arce Rentería
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Miguel Arce Rentería
Jet M.J. Vonk
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Jet M.J. Vonk
Gloria Felix
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Justina F. Avila
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Laura B. Zahodne
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth Dalchand
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kirsten M. Frazer
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Kirsten M. Frazer
Michelle N. Martinez
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Heather L. Shouel
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jennifer J. Manly
From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.M.J.V., G.F., E.D., K.M.F., M.N.M., H.L.S., J.J.M.), Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY; Center for Health Policy (J.F.A.), University of New Mexico, Albuquerque; and Department of Psychology (L.B.Z.), University of Michigan, Ann Arbor.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Jennifer J. Manly
Full PDF
Short Form
Citation
Illiteracy, dementia risk, and cognitive trajectories among older adults with low education
Miguel Arce Rentería, Jet M.J. Vonk, Gloria Felix, Justina F. Avila, Laura B. Zahodne, Elizabeth Dalchand, Kirsten M. Frazer, Michelle N. Martinez, Heather L. Shouel, Jennifer J. Manly
Neurology Dec 2019, 93 (24) e2247-e2256; DOI: 10.1212/WNL.0000000000008587

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
422

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To investigate whether illiteracy was associated with greater risk of prevalent and incident dementia and more rapid cognitive decline among older adults with low education.

Methods Analyses included 983 adults (≥65 years old, ≤4 years of schooling) who participated in a longitudinal community aging study. Literacy was self-reported (“Did you ever learn to read or write?”). Neuropsychological measures of memory, language, and visuospatial abilities were administered at baseline and at follow-ups (median [range] 3.49 years [0–23]). At each visit, functional, cognitive, and medical data were reviewed and a dementia diagnosis was made using standard criteria. Logistic regression and Cox proportional hazards models evaluated the association of literacy with prevalent and incident dementia, respectively, while latent growth curve models evaluated the effect of literacy on cognitive trajectories, adjusting for relevant demographic and medical covariates.

Results Illiterate participants were almost 3 times as likely to have dementia at baseline compared to literate participants. Among those who did not have dementia at baseline, illiterate participants were twice as likely to develop dementia. While illiterate participants showed worse memory, language, and visuospatial functioning at baseline than literate participants, literacy was not associated with rate of cognitive decline.

Conclusion We found that illiteracy was independently associated with higher risk of prevalent and incident dementia, but not with a more rapid rate of cognitive decline. The independent effect of illiteracy on dementia risk may be through a lower range of cognitive function, which is closer to diagnostic thresholds for dementia than the range of literate participants.

Glossary

BIC=
Bayesian Information Criterion;
CI=
confidence interval;
CSES=
childhood socioeconomic status;
WHICAP=
Washington Heights–Inwood Columbia Aging Project

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received November 1, 2018.
  • Accepted in final form June 26, 2019.
  • © 2019 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Study funding
    • Disclosure
    • Appendix Authors
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

Use of Whole-Genome Sequencing for Mitochondrial Disease Diagnosis

Dr. Robert Pitceathly and Dr. William Macken

► Watch

Related Articles

  • No related articles found.

Topics Discussed

  • All Neuropsychology/Behavior
  • All epidemiology
  • All Cognitive Disorders/Dementia
  • Alzheimer's disease
  • Underserved populations

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Article
    Sleep architecture and the risk of incident dementia in the community
    Matthew P. Pase, Jayandra J. Himali, Natalie A. Grima et al.
    Neurology, August 23, 2017
  • Articles
    Retinopathy and risk of dementia
    The Rotterdam Study
    Elisabeth M.C. Schrijvers, Gabriëlle H.S. Buitendijk, M. Kamran Ikram et al.
    Neurology, July 11, 2012
  • Article
    Education and cognitive reserve in old age
    Robert S. Wilson, Lei Yu, Melissa Lamar et al.
    Neurology, February 06, 2019
  • Articles
    Relation between smoking and risk of dementia and Alzheimer disease
    The Rotterdam Study
    C. Reitz, T. den Heijer, C. van Duijn et al.
    Neurology, September 04, 2007
Neurology: 100 (12)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise