Dear Doctor: I read that dementia rates are going down due to rising education levels, but I don't have a college degree. Should I be more worried than most?
Dear Reader: Dementia is a scary disease, causing not only loss of memory but also the inability to reason through problems and, for many, difficulty with even the daily tasks of living. One bright spot is that dementia rates are indeed declining. This was first noted in the United Kingdom in 2013, where researchers in the medical journal Lancet reported a 24 percent decline in dementia rates compared to 20 years previous. The question is: Why the decrease?
A recent study published in the Journal of the American Medical Association attempts to answer that question, assessing differences in dementia rates in the United States between the years of 2000 and 2012. The data were taken from the Health and Retirement Study, which is based on a questionnaire given to thousands of people over the age of 50. The study looked at 10,000 people in 2000 and another 10,000 people in 2012. In this study, researchers found a 24 percent decrease in the dementia rate between 2000 and 2012, and one difference noted by the authors of the study was that overall respondents in 2012 had one more year of education than those in 2000.
A logical question is whether the population in 2012 was simply healthier. That does not appear to be the case. In fact, the 2012 population generally had greater rates of high blood pressure and diabetes, both of which are risk factors for dementia. To that point, it's possible that the more modern and stricter treatments for diabetes and high blood pressure played a role. After all, statins, as well as medications for high blood pressure and diabetes, can reduce the effects of diabetes and high blood pressure on brain function.
But ultimately the authors concluded that the higher level of education was the primary contributor to the decline of both dementia and cognitive impairment. That benefit may come from the creation of greater amounts of brain reserve, so that when brain function decreases years in the future, the effect may not be as obvious.
My belief is that any form of education is important. Although the study above showed that an additional one year of education had benefit, there are other ways of getting an education, such as learning a language. Numerous studies have shown that people who are proficient in two languages have a significant decline in dementia. So if you have the time, learning another language would be a worthy investment.
Please note, however, that I have had patients with high education levels get dementia, so education is not a total preventive.
But I would encourage you to continue to use your mind -- challenging yourself with learning new material and continuing to educate yourself. You don't need to sit in a class for this. A lifelong process of learning and understanding may itself decrease your chances of dementia.
(Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.)
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