Intergenerational educational attainment and risk for incident dementia in a U.S. community-based cohort study: Findings from the Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study

BackgroundIndividuals with higher educational attainment have a lower risk for dementia, including Alzheimer's disease, but it is less clear how the educational attainment of an individual's parents may influence dementia risk, particularly in diverse populations.ObjectiveThis study examined whether intergenerational educational attainment for two adjacent generations was associated with incident dementia risk.MethodsIndividuals from the Atherosclerosis Risk in Communities study were asked about their own educational level (at study baseline, 1987-1989; ages 44-66 years) and, several years later, that of each parent. Dementia status was ascertained from baseline through 2020 using expert committee diagnoses from in-person and telephonic neuropsychological assessments, informant interviews, hospitalization codes, and death certificates. Individuals without dementia at baseline, and with non-missing covariates/ educational history, were included. Educational level was classified (for individuals and the highest-educated parent) as less than high school, completed high school or GED, or more than high school. Cox proportional-hazard models were used to evaluate the association between intergenerational educational attainment and incident dementia risk.ResultsAmong 10,626 individuals (21.8% Black; 55.9% female), models showed that high parental education level and individual education level were each significantly and independently associated with a lower hazard of dementia, although associations were strongest and most consistent for individual education. Individuals whose educational attainment surpassed that of their parents, compared to those with comparable levels, exhibited a significantly lower dementia risk.ConclusionsAn individual's own educational attainment may exert a more significant influence in lowering dementia risk, even when parental education is considered.