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The association between educational level and dementia in rural Tanzania Associação entre nível educacional e demência na zona rural da Tanzânia

Lookup NU author(s): Dr Stella Paddick, Dr Catherine DotchinORCiD, Professor Richard Walker



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


The majority of people with dementia worldwide live in developing countries. Studies from the developed world have reported an association between lower educational attainment and dementia, but there are few data from the developing world where literacy and educational levels are frequently much lower. In this study we assessed the association between education and dementia prevalence in a rural Tanzanian setting. Methods: In phase I, 1198 individuals aged 70 and over were assessed using the Community Screening Instrument for Dementia (CSI-D). In phase Ii a stratified sample of those seen in phase I were fully assessed and a clinical diagnosis based on DSM-IV criteria was made where appropriate. Information regarding literacy, highest attained educational level and occupation were also collected. Results: The median subject cognitive score on the CSI-D was 25.7 (IQR 22.7 to 28.0) for females and 27.7 (IQR 25.7 to 29.4) for males. This difference was significant (U=117770.0, z= -9.880, p<0.001). In both males and females a lower CSI-D subject cognitive score was significantly associated with having had no formal education (U=34866.5, z= -6.688, p<0.001, for females; U=20757.0, z= -6.278, p<0.001, for males). After adjusting for the effect of age, having no formal education was significantly associated with greater odds of having 'probable dementia' by CSI-D, as was illiteracy. Amongst those interviewed in phase II, there was no significant difference in literacy or education between those with diagnosed DSM-IV dementia and those without. Conclusion: In this rural Tanzanian population, we found a significant association between low levels of education and dementia by CSI-D. This relationship was not significant in cases meeting DSM-IV criteria for dementia.

Publication metadata

Author(s): Paddick S-M, Longdon A, Gray WK, Dotchin C, Kisoli A, Chaote P, Walker R

Publication type: Article

Publication status: Published

Journal: Dementia e Neuropsychologia

Year: 2014

Volume: 8

Issue: 2

Pages: 117-125

Print publication date: 01/06/2014

Acceptance date: 29/05/2014

Date deposited: 08/11/2017

ISSN (print): 1980-5764

Publisher: Academia Brasileira de Neurologia



Funder referenceFunder name
an Academy of Medical Sciences (UK) Clinical Lecturer start up grant
part funded by a British Geriatric Society SpR start up grant