Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis
PurposeMany epidemiological studies suggest that lower education levels and vascular risk factors increase the likelihood of developing Alzheimer's disease dementia (ADD) and subcortical vascular dementia (SVaD). However, whether the brain-battering hypothesis can explain the relationship betwe...
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| Format: | Article |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.934149/full |
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| author | Song Hwangbo Song Hwangbo Young Ju Kim Young Ju Kim Yu Hyun Park Yu Hyun Park Hee Jin Kim Hee Jin Kim Duk L. Na Duk L. Na Duk L. Na Duk L. Na Hyemin Jang Hyemin Jang Hyemin Jang Sang Won Seo Sang Won Seo Sang Won Seo Sang Won Seo Sang Won Seo |
| author_facet | Song Hwangbo Song Hwangbo Young Ju Kim Young Ju Kim Yu Hyun Park Yu Hyun Park Hee Jin Kim Hee Jin Kim Duk L. Na Duk L. Na Duk L. Na Duk L. Na Hyemin Jang Hyemin Jang Hyemin Jang Sang Won Seo Sang Won Seo Sang Won Seo Sang Won Seo Sang Won Seo |
| author_sort | Song Hwangbo |
| collection | DOAJ |
| description | PurposeMany epidemiological studies suggest that lower education levels and vascular risk factors increase the likelihood of developing Alzheimer's disease dementia (ADD) and subcortical vascular dementia (SVaD). However, whether the brain-battering hypothesis can explain the relationship between education levels and the clinical diagnosis of dementia remains controversial. The objective of this study was to investigate whether vascular risk factors mediate the association between education level and the diagnosis of amyloid-beta positive (Aβ+) ADD and amyloid-beta negative (Aβ-) SVaD.MethodsWe analyzed 376 participants with Aβ normal cognition (Aβ- NC), 481 with Aβ+ ADD, and 102 with Aβ- SVaD. To investigate the association of education level and vascular risk factors with these diagnoses, multivariable logistic regression analysis was used, with age, sex, and APOE ε4 carrier status used as covariates. Path analysis was performed to investigate the mediation effects of hypertension on the diagnosis of Aβ- SVaD.ResultsThe Aβ- SVaD group (7.9 ± 5.1 years) had lower education levels than did the Aβ- NC (11.8 ± 4.8 years) and Aβ+ ADD (11.2 ± 4.9 years) groups. The frequencies of hypertension and diabetes mellitus were higher in the Aβ- SVaD group (78.4 and 32.4%, respectively) than in the Aβ- NC (44.4 and 20.8%) and Aβ+ ADD (41.8 and 15.8%, respectively) groups. Increased education level was associated with a lower risk of Aβ- SVaD [odds ratio (OR) 0.866, 95% confidence interval (CI), 0.824–0.911], but not Aβ+ ADD (OR 0.971, 95% CI 0.940–1.003). The frequency of hypertension was associated with a higher risk of developing Aβ- SVaD (OR 3.373, 95% CI, 1.908–5.961), but not Aβ+ ADD (OR 0.884, 95% CI, 0.653–1.196). In the path analysis, the presence of hypertension partially mediated the association between education level and the diagnosis of Aβ- SVaD.ConclusionOur findings revealed that education level might influence the development of Aβ- SVaD through the brain-battering hypothesis. Furthermore, our findings suggest that suitable strategies, such as educational attainment and prevention of hypertension, are needed for the prevention of Aβ- SVaD. |
| first_indexed | 2024-04-12T07:56:02Z |
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| language | English |
| last_indexed | 2024-04-12T07:56:02Z |
| publishDate | 2022-08-01 |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-c50d5148d58a45e6b8bf3e7c89ab78ce2022-12-22T03:41:29ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-08-011610.3389/fnins.2022.934149934149Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesisSong Hwangbo0Song Hwangbo1Young Ju Kim2Young Ju Kim3Yu Hyun Park4Yu Hyun Park5Hee Jin Kim6Hee Jin Kim7Duk L. Na8Duk L. Na9Duk L. Na10Duk L. Na11Hyemin Jang12Hyemin Jang13Hyemin Jang14Sang Won Seo15Sang Won Seo16Sang Won Seo17Sang Won Seo18Sang Won Seo19Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaNeuroscience Center, Samsung Medical Center, Seoul, South KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaNeuroscience Center, Samsung Medical Center, Seoul, South KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaNeuroscience Center, Samsung Medical Center, Seoul, South KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaNeuroscience Center, Samsung Medical Center, Seoul, South KoreaDepartment of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South KoreaStem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, South KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaNeuroscience Center, Samsung Medical Center, Seoul, South KoreaSamsung Alzheimer Convergence Research Center, Samsung Medical Center, Seoul, South KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaNeuroscience Center, Samsung Medical Center, Seoul, South KoreaDepartment of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South KoreaSamsung Alzheimer Convergence Research Center, Samsung Medical Center, Seoul, South KoreaDepartment of Intelligent Precision Healthcare Convergence, Sungkyunkwan University School of Medicine, Suwon, South KoreaPurposeMany epidemiological studies suggest that lower education levels and vascular risk factors increase the likelihood of developing Alzheimer's disease dementia (ADD) and subcortical vascular dementia (SVaD). However, whether the brain-battering hypothesis can explain the relationship between education levels and the clinical diagnosis of dementia remains controversial. The objective of this study was to investigate whether vascular risk factors mediate the association between education level and the diagnosis of amyloid-beta positive (Aβ+) ADD and amyloid-beta negative (Aβ-) SVaD.MethodsWe analyzed 376 participants with Aβ normal cognition (Aβ- NC), 481 with Aβ+ ADD, and 102 with Aβ- SVaD. To investigate the association of education level and vascular risk factors with these diagnoses, multivariable logistic regression analysis was used, with age, sex, and APOE ε4 carrier status used as covariates. Path analysis was performed to investigate the mediation effects of hypertension on the diagnosis of Aβ- SVaD.ResultsThe Aβ- SVaD group (7.9 ± 5.1 years) had lower education levels than did the Aβ- NC (11.8 ± 4.8 years) and Aβ+ ADD (11.2 ± 4.9 years) groups. The frequencies of hypertension and diabetes mellitus were higher in the Aβ- SVaD group (78.4 and 32.4%, respectively) than in the Aβ- NC (44.4 and 20.8%) and Aβ+ ADD (41.8 and 15.8%, respectively) groups. Increased education level was associated with a lower risk of Aβ- SVaD [odds ratio (OR) 0.866, 95% confidence interval (CI), 0.824–0.911], but not Aβ+ ADD (OR 0.971, 95% CI 0.940–1.003). The frequency of hypertension was associated with a higher risk of developing Aβ- SVaD (OR 3.373, 95% CI, 1.908–5.961), but not Aβ+ ADD (OR 0.884, 95% CI, 0.653–1.196). In the path analysis, the presence of hypertension partially mediated the association between education level and the diagnosis of Aβ- SVaD.ConclusionOur findings revealed that education level might influence the development of Aβ- SVaD through the brain-battering hypothesis. Furthermore, our findings suggest that suitable strategies, such as educational attainment and prevention of hypertension, are needed for the prevention of Aβ- SVaD.https://www.frontiersin.org/articles/10.3389/fnins.2022.934149/fullAlzheimer's diseasevascular dementiaeducationhypertensionvascular risk factor |
| spellingShingle | Song Hwangbo Song Hwangbo Young Ju Kim Young Ju Kim Yu Hyun Park Yu Hyun Park Hee Jin Kim Hee Jin Kim Duk L. Na Duk L. Na Duk L. Na Duk L. Na Hyemin Jang Hyemin Jang Hyemin Jang Sang Won Seo Sang Won Seo Sang Won Seo Sang Won Seo Sang Won Seo Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis Frontiers in Neuroscience Alzheimer's disease vascular dementia education hypertension vascular risk factor |
| title | Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis |
| title_full | Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis |
| title_fullStr | Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis |
| title_full_unstemmed | Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis |
| title_short | Relationships between educational attainment, hypertension, and amyloid negative subcortical vascular dementia: The brain-battering hypothesis |
| title_sort | relationships between educational attainment hypertension and amyloid negative subcortical vascular dementia the brain battering hypothesis |
| topic | Alzheimer's disease vascular dementia education hypertension vascular risk factor |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.934149/full |
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