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Mediators of educational differences in dementia risk later in life: evidence from the HUNT study
Teferi Mekonnen, Vegard Skirbekk, Asta Kristine Haberg, Bo Engdahl, Ekaterina Zotcheva, Astanand Jugessur, Catherine E. Bowen, Geir Selbæk et al.. BMC Public Health, 2025-04-10
Topic: Risk, prevention and care in population studies
Despite a well-known inverse association between education and dementia risk, the mediating mechanisms are not well understood. We explored how lifestyle and health risk factors across the life-course mediate the relationship between education and dementia among adults aged 70 + years. We included 7,655 participants with dementia diagnoses and education information, using a historical cohort design linking prospective exposure data across the life course from the HUNT4 70 + Study with registry data from Statistics Norway and earlier HUNT surveys. We conducted causal mediation analysis to assess the mediating roles of occupational characteristics, lifestyle factors (smoking, physical inactivity), and health risk factors (obesity, hypertension, diabetes, hearing impairment, cardiovascular diseases, LDL cholesterol, depression, anxiety) assessed during early, middle, and late adulthood in the relationship between education and dementia in later life. Participants with lower education were more likely to have dementia with odds ratios of 1.99, 1.88, 1.83 for the model's accounting exposure to mediators during early, middle, and late adulthood, respectively. These associations were partially mediated by the joint effect of health and lifestyle risk factors from early through late adulthood (mediated 11.55-19.50%). Health risk factors from early to late adulthood jointly mediated 6.85-13.06% of the effect of low education on dementia risk later in life. Additionally, lifestyle factors during middle and late adulthood jointly mediated 4.11-4.96% of the total effect of low education on dementia risk later in life. Educational differences in dementia risk can partly mediated by lifestyle and health factors across the life course. These findings suggest potential targets to address varying dementia risks linked to education levels.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mekonnen, T., Skirbekk, V., Haberg, A. K., Engdahl, B., Zotcheva, E., Jugessur, A., et al. (2025). Mediators of educational differences in dementia risk later in life: evidence from the HUNT study. BMC Public Health. https://doi.org/10.1186/s12889-025-22592-9
Vancouver
Mekonnen T, Skirbekk V, Haberg AK, Engdahl B, Zotcheva E, Jugessur A, et al. Mediators of educational differences in dementia risk later in life: evidence from the HUNT study. BMC Public Health. 2025. doi:10.1186/s12889-025-22592-9. PMID: 40211155.
BibTeX
@article{mekonnen2025-40211155,
author = {Mekonnen, Teferi and Skirbekk, Vegard and Haberg, Asta Kristine and Engdahl, Bo and Zotcheva, Ekaterina and Jugessur, Astanand and Bowen, Catherine E. and Selbæk, Geir and others},
title = {{Mediators of educational differences in dementia risk later in life: evidence from the HUNT study}},
journal = {BMC Public Health},
year = {2025},
doi = {10.1186/s12889-025-22592-9},
pmid = {40211155},
url = {https://doi.org/10.1186/s12889-025-22592-9}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- These findings suggest potential targets to address varying dementia risks linked to education levels.
Why it matters
Among 7,655 adults aged 70 and over, lower education was associated with higher odds of dementia, and health and lifestyle risk factors from early through late adulthood partially mediated this link. The authors suggest these factors may be targets to address differences in dementia risk related to education.
Study details
- Participants7,655
- Effect size19.50%; 13.06%; 4.96%
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC Public Health) |
| Journal's citation record | 3 / 4 | BMC Public Health: journal h-index 289 (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 | 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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 7,655 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 2 / 7 | Cited 8 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 5.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Bjørn Heine Strand: h-index 44 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Pennsylvania: institution h-index 1,859 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 12 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40211155) |
| Free to read | 2 / 2 | Free to read |
| Total | 53 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s12889-025-22592-9
- PubMed: 40211155
- Original source →
- Free full text: BMC Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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