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69/100

✓ Peer-reviewed alzhub usefulness score 69 out of 100. How common it is

Topic: Amyloid, tau and blood-test diagnosis

Objective Several cross-sectional studies have found an association between Alzheimer's disease (AD) and limited educational experience. It has been difficult to establish whether educational experience is a risk factor for AD because educational attainment can influence performance on diagnostic tests. This study was designed to determine whether limited educational level and occupational attainment are risk factors for incident dementia. Design Cohort incidence study. Setting General community. Participants A total of 593 nondemented individuals aged 60 years or older who were listed in a registry of individuals at risk for dementia in North Manhattan, NY, were identified and followed up. Interventions We reexamined subjects 1 to 4 years later with the identical standardized neurological and neuropsychological measures. Main outcome measures Incident dementia. Results We used Cox proportional hazards models, adjusting for age and gender, to estimate the relative risk (RR) of incident dementia associated with low educational and occupational attainment. Of the 593 subjects, 106 became demented; all but five of these met research criteria for AD. The risk of dementia was increased in subjects with either low education (RR, 2.02; 95% confidence interval [Cl], 1.33 to 3.06) or low lifetime occupational attainment (RR, 2.25; 95% Cl, 1.32 to 3.84). Risk was greatest for subjects with both low education and low life-time occupational attainment (RR, 2.87; 95% Cl, 1.32 to 3.84). Conclusions The data suggest that increased educational and occupational attainment may reduce the risk of incident AD, either by decreasing ease of clinical detection of AD or by imparting a reserve that delays the onset of clinical manifestations.

Key findings

Results We used Cox proportional hazards models, adjusting for age and gender, to estimate the relative risk (RR) of incident dementia associated with low educational and occupational attainment.
Conclusions The data suggest that increased educational and occupational attainment may reduce the risk of incident AD, either by decreasing ease of clinical detection of AD or by imparting a reserve that delays the onset of clinical manifestations.

Why it matters

In this 1994 study, 593 people aged 60 or over in North Manhattan, none of whom had dementia, were tested again 1 to 4 years later; 106 developed dementia, all but five of them Alzheimer's disease. After allowing for age and sex, people with low education had about twice the risk (RR 2.02) and people in low-attainment jobs had a similar increase (RR 2.25), with the highest risk in those low on both. The authors say this may mean education and work either make Alzheimer's harder to detect on tests or give a reserve that delays symptoms; it is an association, not proof that more education prevents the disease.

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Study details

Study designcross-sectional
Participants593
Evidence strengthModerate

How this study scored 69/100

Published in a top-tier journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	10 / 10	Tier 1 — top-tier general journal (JAMA)
Journal's citation record	4 / 4	JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29)
Study design	4 / 12	A snapshot of people at one point in time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	1994 — older than 20 years, still counted
Sample size	2 / 4	593 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	7 / 7	Cited 1,439 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	42.3 citations a year over 34 year(s) since 1994
Impact for its field and year	5 / 6	Cited 22.5× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	4 / 6	Cited by 89 other studies in this library
Still being cited	3 / 4	Cited 114 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Yaakov Stern: h-index 162 (OpenAlex, whole career)
Institution's track record	2 / 3	Columbia University: institution h-index 1,824 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 8139057)
Free to read	0 / 2	Behind a paywall — scores zero
Total	69 / 100	—

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Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

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

Stern, Y., Gurland, B., Tatemichi, T. K., Tang, M. X., Wilder, D., & Mayeux, R. (1994). Influence of education and occupation on the incidence of Alzheimer's disease. JAMA. https://doi.org/10.1001/jama.1994.03510370056032

Vancouver

Stern Y, Gurland B, Tatemichi TK, Tang MX, Wilder D, Mayeux R. Influence of education and occupation on the incidence of Alzheimer's disease. JAMA. 1994. doi:10.1001/jama.1994.03510370056032. PMID: 8139057.

BibTeX

@article{stern1994-8139057,
  author  = {Stern, Y. and Gurland, B. and Tatemichi, T. K. and Tang, M. X. and Wilder, D. and Mayeux, R.},
  title   = {{Influence of education and occupation on the incidence of Alzheimer's disease}},
  journal = {JAMA},
  year    = {1994},
  doi     = {10.1001/jama.1994.03510370056032},
  pmid    = {8139057},
  url     = {https://doi.org/10.1001/jama.1994.03510370056032}
}

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