EDUCATION AND OTHER MEASURES OF SOCIOECONOMIC-STATUS AND RISK OF INCIDENT ALZHEIMER-DISEASE IN A DEFINED POPULATION OF OLDER PERSONS

Objective: To assess the relations of 3 measures of socioeconomic stat us (education, occupational prestige, and income) to risk of incident clinically diagnosed Alzheimer disease (AD). Design: Cohort study with an average observation of 4.3 years. Setting: East Boston, Mass, a ge ographically defined community. Participants: A stratified random samp le of 642 community residents 65 years of age and older who were free of AD at baseline. Main Outcome Measure: Clinical diagnosis of probabl e AD according to standard criteria, using structured uniform evaluati on. Results: The relations of the 3 measures of socioeconomic status t o risk of disease were assessed using logistic regression analyses. In individual analyses, fewer years of formal schooling, lower income, a nd lower occupational status each predicted risk of incident AD; risk of disease decreased by approximately 17% for each year of education. In an analysis including all 3 measures, the effect of education on ri sk for disease remained approximately the same, but the effects of the other 2 measures were somewhat less and did not attain formal statist ical significance, compared with separate analysis of each measure. Co nclusions: Markers of lower socioeconomic status predict risk of devel oping incident AD. The mechanism of this relation is uncertain, but th e possibility that it reflects unidentified and potentially reversible risk factors for the disease deserves careful investigation.