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Education and change in cognitive function. The Epidemiologic Catchment Area Study
Farmer ME, Kittner SJ, Rae DS, Bartko JJ, Regier DA.. Annals of epidemiology, 1995-01-01
Topic: Risk, prevention and care in population studies
The association between educational attainment and decline in cognitive function over an interval of 1 year was examined for 14,883 subjects 18 years and older in the National Institute of Mental Health Epidemiologic Catchment Area Study. Cognitive function was assessed at both time points by the Mini-Mental State Examination (MMSE); cognitive decline was coded as a dichotomous variable and was defined as 1 if the subject's score had declined 3 or more points from the baseline MMSE score at the 1-year follow-up interview and as 0 otherwise. The association between educational attainment and decline in cognitive function over 1 year was examined in logistic regression models that were stratified by age group ( or = 65 years) and by baseline MMSE level (MMSE > 23, MMSE 23, education was a significant predictor of cognitive decline, not only in the elderly but also in younger subjects.
Key findings
- Cognitive function was assessed at both time points by the Mini-Mental State Examination (MMSE); cognitive decline was coded as a dichotomous variable and was defined as 1 if the subject's score had declined 3 or more points from the baseline MMSE score at the 1-year follow-up interview and as 0 otherwise.
- The association between educational attainment and decline in cognitive function over 1 year was examined in logistic regression models that were stratified by age group ( or = 65 years) and by baseline MMSE level (MMSE > 23, MMSE 23, education was a significant predictor of cognitive decline, not o
- Among those with baseline MMSE < or = 23, education was not a significant predictor of cognitive decline.
- The fact that education provides protection against cognitive decline even in those younger than 65 years, in whom the prevalence and incidence of dementia are very low, would seem to indicate that education or its correlates provides protection against processes other than dementia that might produce a decline in test performance in young persons.
Why it matters
This study examined the link between educational attainment and one-year decline in cognitive function in 14,883 people aged 18 and older. It is about education and cognitive change in the general population and does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Participants14,883
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Annals of epidemiology) |
| Journal's citation record | 2 / 4 | Annals of Epidemiology: journal h-index 184 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1995 — older than 20 years, still counted |
| Sample size | 4 / 4 | 14,883 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 199 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.0 citations a year over 33 year(s) since 1995 |
| Impact for its field and year | 3 / 6 | Cited 3.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Darrel A. Regier: h-index 68 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | National Institutes of Health: institution h-index 2,723 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 7728280) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Farmer, M. E., Kittner, S. J., Rae, D. S., Bartko, J. J., & Regier, D. A. (1995). Education and change in cognitive function. The Epidemiologic Catchment Area Study. Annals of epidemiology. https://doi.org/10.1016/1047-2797(94)00047-w
Vancouver
Farmer ME, Kittner SJ, Rae DS, Bartko JJ, Regier DA. Education and change in cognitive function. The Epidemiologic Catchment Area Study. Annals of epidemiology. 1995. doi:10.1016/1047-2797(94)00047-w. PMID: 7728280.
BibTeX
@article{farmer1995-7728280,
author = {Farmer, M. E. and Kittner, S. J. and Rae, D. S. and Bartko, J. J. and Regier, D. A.},
title = {{Education and change in cognitive function. The Epidemiologic Catchment Area Study}},
journal = {Annals of epidemiology},
year = {1995},
doi = {10.1016/1047-2797(94)00047-w},
pmid = {7728280},
url = {https://doi.org/10.1016/1047-2797(94)00047-w}
}
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