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Illiteracy and the incidence of Alzheimer's disease in the Yonchon County survey, Korea

Published online by Cambridge University Press:  01 May 2008

Jun-Young Lee
Affiliation:
Department of Psychiatry, Seoul National University Boramae Hospital, Korea
Sung Man Chang
Affiliation:
Department of Psychiatry and Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Korea
Hong-Suk Jang
Affiliation:
Department of Psychiatry, Incheon Medical Center, Korea
Jae Seung Chang
Affiliation:
Department of Psychiatry, Seoul Municipal Eunpyeong Hospital, Korea
Guk-Hee Suh
Affiliation:
Department of Psychiatry, Hallym University College of Medicine, Hangang Sacred Heart Hospital, Korea
Hee-Yeon Jung
Affiliation:
Department of Psychiatry, Seoul National University Boramae Hospital, Korea
Hong-Jin Jeon
Affiliation:
Department of Psychiatry and Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Korea
Maeng Je Cho*
Affiliation:
Department of Psychiatry and Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Korea
*
Correspondence should be addressed to: Maeng Je Cho, Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea. Phone: +82 2 20723155; Fax: +82 2 7447241. Email: mjcho@plaza.snu.ac.kr.

Abstract

Background: This study aims to establish the incidence rates of Alzheimer's disease (AD) and to understand the relations between illiteracy and AD in the Korean Yonchon survey cohort.

Methods: A community-based, dementia-free cohort of 966 people aged 65 years and older was followed up for an average of 5.4 ± 1.60 years to detect incident AD cases using a two-phase procedure. Age-specific incidence rates were calculated using a person-years approach with Poisson distribution confidence intervals. Data were analyzed using the Cox proportional hazards model to find the hazard ratio of illiteracy.

Results: The participating percentage of the survivors was 86.4% and 74 subjects were diagnosed with AD. Incidence rates per 1000 person-years were 20.99 (95% CI 16.48 to 26.35) for AD. The hazard ratio of illiteracy was 1.78 (95% CI 1.08 to 2.93) adjusted for age, sex, educational level. AD developed more rapidly with aging in the illiterate group than in the literate group.

Conclusions: Illiteracy is associated with a higher risk of AD and the risk increases with age.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2008

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References

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn revised. Washington, DC: American Psychiatric Association.Google Scholar
Castro-Caldas, A., Petersson, K. M., Reis, A., Stone-Elander, S. and Ingvar, M. (1998). The illiterate brain. Learning to read and write during childhood influences the functional organization of the adult brain. Brain, 121, 10531063.Google Scholar
Cho, M. J., Park, I. M. and Shin, Y. M. (2000). A validation study for the Korean version of Psychogeriatric Assessment Scale. Journal of the Korean Neuropsychiatric Association, 39, 128141.Google Scholar
Cobb, J. L., Wolf, P. A., Au, R., White, R. and D'Agostino, R. B. (1995). The effect of education on the incidence of dementia and Alzheimer's disease in the Framingham Study. Neurology, 45, 17071712.Google Scholar
Fratiglioni, L., De Ronchi, D. and Aguero-Torres, H. (1999). Worldwide prevalence and incidence of dementia. Drugs Aging, 15, 365375.Google Scholar
Hart, S. (1988). Language and dementia: a review. Psychological Medicine, 18, 99112.Google Scholar
Jorm, A. F. et al. (1995). The Psychogeriatric Assessment Scales: a multi-dimensional alternative to categorical diagnoses of dementia and depression in the elderly. Psychological Medicine, 25, 447460.CrossRefGoogle Scholar
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer's disease. Neurology, 43, 1320.CrossRefGoogle ScholarPubMed
Letenneur, L., Gilleron, V., Commenges, D., Helmer, C., Orgogozo, J. M. and Dartigues, J. F. (1999). Are sex and educational level independent predictors of dementia and Alzheimer's disease? Incidence data from the PAQUID project. Journal of Neurology, Neurosurgery and Psychiatry, 66, 177183.Google Scholar
Letenneur, L. et al. (2000). Education and the risk for Alzheimer's disease: sex makes a difference. EURODEM pooled analyses. EURODEM Incidence Research Group. American Journal of Epidemiology, 151, 10641071.Google Scholar
Manly, J. J., Touradji, P., Tang, M. X. and Stern, Y. (2003). Literacy and memory decline among ethnically diverse elders. Journal of Clinical and Experimental Neuropsychology, 25, 680690.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Qiu, C., Backman, L., Winblad, B., Aguero-Torres, H. and Fratiglioni, L. (2001). The influence of education on clinically diagnosed dementia incidence and mortality data from the Kungsholmen Project. Archives of Neurology, 58, 20342039.Google Scholar
Roe, C. M., Xiong, C., Miller, J. P. and Morris, J. C. (2007). Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. Neurology, 68, 223228.Google Scholar
Snowdon, D. A., Greiner, L. H. and Markesbery, W. R. (2000). Linguistic ability in early life and the neuropathology of Alzheimer's disease and cerebrovascular disease. Findings from the Nun Study. Annals of the New York Academy of Science, 903, 3438.CrossRefGoogle ScholarPubMed
Suh, G. H., Kim, J. K. and Cho, M. J. (2003). Community study of dementia in the older Korean rural population. Australian and New Zealand Journal of Psychiatry, 37, 606612.Google Scholar
Terry, R. D. and Katzman, R. (2001). Life span and synapses: will there be a primary senile dementia? Neurobiology of Aging, 22, 347348; discussion 353354.CrossRefGoogle ScholarPubMed
UNESCO. (2003). Literacy as Freedom. http://portal.unesco.org/education/en/.Google Scholar
Whalley, L. J., Starr, J. M., Athawes, R., Hunter, D., Pattie, A. and Deary, I. J. (2000). Childhood mental ability and dementia. Neurology, 55, 14551459.Google Scholar
Zhou, D. F. et al. (2006). Prevalence of dementia in rural China: impact of age, gender and education. Acta Neurologica Scandinavica, 114, 273280.Google Scholar