Table 5.
EdQ-adjusted relationship between race and dementia using different combinations of parameter estimates from the literature.
| Race-specific proportions of low education quality | HREdQ-dementia (95% CI) | HRrace-dementia (95%CI) | EdQ-Adjusteda HRrace-dementia (95%CI) |
Percent attenuatedb from EdQ-Adjustment |
|---|---|---|---|---|
| pB = 0.443 pw = 0.104 EdQ = Limited literacy (<9th grade reading level) (Kaup et al.; Health ABC) | 1.53 (1.17, 2.00) EdQ = Limited literacy (<9th grade reading level) (Health ABC) Risk of likely dementia; adjusted for age, sex, race, education, income (Kaup et al., Health ABC) | 2.0 (1.43, 2.74) Adjusted for education, comorbidities, APOE4 (Shadlen et al., CHS) | 1.71 (1.22, 2.34) | 29% |
| 1.37 (1.12, 1.67) Adjusted for age, sex, APOE4, BMI, history of stroke or myocardial infarction, hypertension, diabetes, depression, current smoking, alcohol use, physical activity (Yaffe et al., Health ABC) | 1.17 (0.96, 1.43) d | 54% | ||
| 1.70 (1.41, 2.05) EdQ = Limited literacy (<9th grade reading level) (Health ABC) Risk of incident dementia; unadjusted (Yaffe et al., Health ABC) | 2.0 (1.43, 2.74) | 1.64 (1.17, 2.24) | 36% | |
| 1.37 (1.12, 1.67) | 1.12 (0.92, 1.37) d | 67.6% | ||
| pB = 0.24 pW = 0.07 EdQ = Below-basic literacy (NCES)c | 1.53 (1.17, 2.00) | 2.0 (1.43, 2.74) | 1.84 (1.32, 2.52) | 16% |
| 1.37 (1.12, 1.67) | 1.26 (1.03, 1.54) | 29.7% | ||
| 1.70 (1.41, 2.05) | 2.0 (1.43, 2.74) | 1.80 (1.28, 2.46) | 20% | |
| 1.37 (1.12, 1.67) | 1.23 (1.01, 1.50) | 37.8% | ||
| pB = 0.711 pW = 0.329 EdQ = Student-teacher ratio ≥29 (Sisco et al., HRS) | 1.53 (1.17, 2.00) | 2.0 (1.43, 2.74) | 1.71 (1.22, 2.34) | 29% |
| 1.37 (1.12, 1.67) | 1.17 (0.96, 1.42) d | 54% | ||
| 1.70 (1.41, 2.05) | 2.0 (1.43, 2.74) | 1.64 (1.17, 2.25) | 36% | |
| 1.37 (1.12, 1.67) | 1.13 (0.92, 1.37) d | 64.8% |
a
Equation used: HRrace-dementia, adjusted for U = HRrace-dementia/[(1+(HREdQ-dementia-1)*pB)/(1+(HREdQ-dementia-1)*pw)]; where pB = proportion of Black participants with low EdQ; pW = proportion of White participants with low EdQ; definition of low EdQ specified for each estimate.
b
Percent attenuation defined according to percent attenuation in excess risk (HR-1/HR) from the unadjusted to the EdQ-Adjusted HR.
c
Defined as “no more than the most simple and concrete literacy skills” in the domains of prose, document and quantitative literacy in 2003 (nces.ed.gov/naal/pdf/2006470_1.pdf).
d
Confidence interval crosses HR = 1.