Illiteracy and dementia

Abstract

There is a current concept that illiteracy and lower educational levels are risk factors for cognitive decline and dementia. Our aims were to review the association between illiteracy and dementia; and to describe some results on neuropsychological findings in illiteracy. A literature search of the PubMed database was performed. The search terms were “dementia”, “illiteracy”, “neuropsychological evaluation”, “educational levels”, and “education”. Only papers published in Portuguese, English, and Spanish were reviewed. Illiteracy is an incontestable risk factor for dementia. It influences performance on almost cognitive tests. Many other factors could be connected to the high prevalence of dementia among illiterates: low cognitive reserve, poor control of cerebrovascular disease risk factors, difficulties in cognitive evaluation, and poor adaptation of neuropsychological tests for this specific population. Functional tests must be coupled with cognitive tests to ameliorate diagnostic accuracy.

Escala de Avaliação da Doença de Alzheimer - Subescala Cognitiva (ADAS-Cog): Dados Normativos para a População Portuguesa

“…The decision was based on the fact that there is evidence of floor effects in cognitive batteries that are purportedly unaffected by education like ADAS-Cog. 29,37 Cognitive evaluation needs to be adapted to ensure the reliability of scores obtained by illiterates, because illiteracy seems to influence cognitive processes well beyond the ability to read or write. Specifically, illiteracy affects language, praxis, and visuospatial abilities -all of which are main components of ADAS-Cog.…”

“…17 Finally, phonemic verbal fluency and speech are also prone to the effects of education. 37,38 Therefore, we believe that ADAS-Cog needs to be adapted to this special population -namely the structure, the items, the administration, and the scoring system should be modified to ensure the reliability of scores obtained by illiterate individuals.…”

The association between educational level and dementia in rural Tanzania

“… 48 A meta-analysis of illiteracy and dementia risk reported a strong association. 19 Studies from Nigeria have reported a proportion of individuals learning to read and write through informal methods such as attendance at religious education classes. 29 , 31 In Hai, few participants reported having attended adult education classes, and only 1% of those who had no formal schooling were able to read and write, suggesting that in Hai informal or alternative education was not prevalent.…”

Tarefas de Nomeação Seriada Rápida: Rastreando a Dificuldade de Leitura

“…Uma nova forma de acesso à informação se torna disponível, o que amplia consideravelmente as possibilidades de desenvolvimento do indivíduo, seja no âmbito social, emocional, cognitivo ou cerebral. Sabe-se hoje que não saber ler e escrever é um fator de risco para o desenvolvimento de demências (Brucki, 2010) e que a doença de Alzheimer progride mais rapidamente entre as pessoas que não leem do que entre as pessoas que leem (Lee et al, 2008).…”