EDUCATION AND THE RISK OF PHYSICAL-DISABILITY AND MORTALITY AMONG MENAND WOMEN AGED 65 TO 84 - THE ITALIAN LONGITUDINAL-STUDY ON AGING

Background Most studies report that people with higher education enjoy better health and longer life. Although it is well known that most ri sk factors are more common among individuals with a lower level of edu cation, the underlying mechanism of this association is not fully unde rstood. The objective of this study was to assess the association betw een education, disability, and mortality. Methods. We analyzed data on 1,817 men and 1,643 women, aged 65-84 years, to assess the associatio n of educational level with physical disability and mortality adjustin g for age, sex, smoking habit, occupation, and major chronic condition s. Results. The association between educational level and disability w as characterized by a dose-response effect, with the relative odds sig nificantly decreased by about 30%, 60%, and 79% in those with 4 or 5, 6 to 8, and more than 8 years of education, compared to those with 3 o r less years of education. Death rates were lower among persons with 4 or more years of education compared to those with less education. How ever, after adjusting for disability status, education was no longer a ssociated with mortality (RR = 0.97, CI = 0.65-1.43). Conclusions. The strong association of low education with disability found in this stu dy may explain the inverse association with mortality reported in prev ious studies. Disability, indeed, seems to be the mediator between edu cation and mortality and might be due to the higher severity level of diseases, leading to death, in the lower educated group.