Decline in Literacy and Incident AD Dementia Among Community-Dwelling Older Persons. (October 2018)

• Record Type: Journal Article
• Authors: Yu, Lei; Wilson, Robert S.; Han, S. Duke; Leurgans, Sue; Bennett, David A.; Boyle, Patricia A.
• Is Part Of: Journal of aging and health. Volume 30:Number 9(2018)
• Page Start: 1389
• Page End: 1405
• Publication Date: 2018-10
• Subjects: aging -- domain-specific literacy -- AD dementia -- mild cognitive impairment; Older people -- Health and hygiene -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1177/0898264317716361
• Languages: English
• ISSNs: 0898-2643

Abstract

Objective: To quantify longitudinal change in financial and health literacy and examine the associations of declining literacy with incident Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI).Method: Data came from 799 participants of an ongoing cohort study. Literacy was measured using a battery of 32 questions. Clinical diagnoses were made annually following uniform structured procedures. The associations of declining literacy with incident AD dementia and MCI were tested using a joint model for longitudinal and time-to-event data.Results: We observed an overall decline in total literacy score over up to 6 years of follow-up ( p < .001). Faster decline in literacy was associated with higher risks for incident AD dementia (hazard ratio = 4.526, 95% confidence interval = [2.993, 6.843], p < .001) and incident MCI (hazard ratio = 2.971, 95% confidence interval = [1.509, 5.849], p = .002).Discussion: Declining literacy among community-dwelling older persons predicts adverse cognitive outcomes and serves as an early indicator of impending dementia.