School attainment in childhood is an independent risk factor of dementia in late life: results from a Brazilian sample

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.