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Lookup NU author(s): Professor Raj KalariaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 The Alzheimer's Association. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association. BACKGROUND: Education is a crucial social determinant of health, influencing opportunities, socioeconomic status, and health outcomes. Regional disparities in educational attainment and their effects on cognitive health are especially notable in low- and middle-income countries (LMICs), where access to education and healthcare varies widely. This study explores the role of education in health disparities, focusing on two distinct African regions-Western and Eastern Africa-using data from the READD-ADSP DAWN Study. METHOD: This cross-sectional study analyzed data from Western Africa (n = 756) and Eastern Africa (n = 689). Variables included early-life learning disability, special education participation, educational attainment (None, Elementary, High School, College, Graduate/Professional), and cognitive health diagnoses (Non-Cognitively Impaired, MCI, AD, Dementia, Other or No Diagnosis). A Wilcoxon rank sum test assessed differences in educational attainment between cognitive diagnostic groups. Logistic regression with a logit link function examined the relationship between years of education and the likelihood of a primary diagnosis of Alzheimer's Disease or Dementia. RESULT: In the Eastern region sample, the Wilcoxon rank sum test revealed a significant difference in education levels between individuals with and without a cognitive health diagnosis (W=68233, p <0.001). Logistic regression showed that education was a significant predictor of diagnosis (β=-0.04891, SE=0.01641, z=-2.980, p = 0.00288). Higher education levels were associated with lower odds of a cognitive health diagnosis. The model fit was reasonable, with a residual deviance of 927.65 and an AIC of 931.65. In the Western region sample, the Wilcoxon rank sum test also showed a significant difference in education levels between individuals with and without a cognitive health diagnosis (W=81364, p = 0.02669). Logistic regression confirmed that years of education significantly predicted diagnosis status (β=-0.02640, SE=0.01076, z=-2.454, p = 0.0141), with higher education linked to lower odds of being diagnosed with a cognitive health diagnosis. The model fit was adequate, with a residual deviance of 1060.2 and an AIC of 1064.2. CONCLUSION: These findings further support the protective role of education against cognitive decline in both regions.
Author(s): Scaramutti C, Seixas AA, Cai D, Rajabli F, Adams LD, Hamilton-Nelson KL, Cuccaro ML, Ayele BA, Griswold AJ, McInerney KF, Kunkle BW, Adams LD, Whitehead PG, Vance JM, Cuccaro ML, Griswold AJ, Blanton SH, Kunkle BW, Vance JM, Cuccaro ML, Dorfsman DA, Scott KM, Whitehead PG, Zaman AF, Griswold AJ, Blanton SH, McInerney KF, Mena PR, Martinez IM, Kunkle BW, Vance JM, Pericak-Vance M, Seixas AA, Akinyemi JO, Coker M, Diala S, Ogunronbi M, Baiyewu O, Ogunniyi A, African Dementia Consortium, Akinyemi RO, Akinyemi JO, Coker M, Akinwande K, Damasceno A, Ndetei D, Zewde YZ, Ayele BA, Byrd GS, Caban-Holt AM, Ndetei D, Ndetei D, Sarfo FS, Akpalu A, Wahab K, McInerney KF, Vance JM, Obiako R, Okubadejo NU, Owolabi MO, Kunkle BW, Reitz C, Reitz C, Tosto G, Bush WS, Williams SM, Haines JL, Kalaria R, Ogunniyi A, Pericak-Vance M
Publication type: Article
Publication status: Published
Journal: Alzheimer's & Dementia
Year: 2025
Volume: 21
Issue: S6
Online publication date: 23/12/2025
Acceptance date: 02/04/2018
Date deposited: 08/01/2026
ISSN (print): 1552-5260
ISSN (electronic): 1552-5279
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1002/alz70860_107528
DOI: 10.1002/alz70860_107528
PubMed id: 41434240
Notes: Supplement: Public Health
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