The study tested whether education causally affects Alzheimer's disease and related dementias (ADRD). It compared cohorts either side of a compulsory schooling reform, using a regression discontinuity design. ADRD was identified from medical history, hospital records and death registries, which limits bias from selective attrition. Extra education reduced ADRD incidence. Molecular genetic data showed the reform also weakened the association between genetic risk and ADRD incidence. The findings rest on a single schooling reform.
Why it is interesting: Causal evidence on factors that protect against dementia is scarce. Here a social policy changed how strongly genetic risk predicted dementia.
Abstract — the authors' own words, CC BY
There is little causal evidence on factors that can protect individuals against Alzheimer's Disease and Related Dementias (ADRD) risk. We study the causal effect of education on ADRD, exploiting a regression discontinuity generated by a compulsory schooling reform. ADRD was ascertained based on medical history, hospital records, and death registries, addressing concerns about selective sample attrition. We find that education reduces incidence of ADRD. Using molecular genetic data, we show that the reform weakened the relationship between genetics and ADRD incidence, implying genetic risk of dementia is not immutable and can be modified by social policy.
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