Effects of demographic and environmental variables on cognitive performance in a rural community sample of elderly people living in Southern Italy

Abstract

This finding is consistent with other epidemiologic surveys, and suggests the possible role of ecological and environmental factors in preventing or compensating cognitive decline, at least in persons coming from homogeneous rural areas. Low social demands in a protective family environment do not stimulate high intellectual performance, and signs of dementia may not be recognized by persons living in this context until the patient reaches a severe stage of disease.

Role of functional performance in diagnosis of dementia in elderly people with low educational level living in Southern Italy

“…Multiple regression analysis on MMSE scores in NS (dependent variable), assuming age, sex and education as independent variables, showed the strong positive effect of years of education (co-efficient=0.668, t=7.735, p<0.0001), with no effect of age or gender. This result replicated data shown in our previous study (15). Assuming total MMSE scores as dependent variable and years of education as covariate, the ANCOVA showed the high power of scores in discriminating DP from NS (F(1, 289)=34.372, p<0.0001).…”

“…There were less NS than in the previous study (15), since only persons who fully completed the functional assessment were included in the present evaluation ( Table 1).…”

“…Verbal informed consent to use data was obtained from all subjects after the procedure had been explained. Recruitment and randomization procedures have been described elsewhere (15).…”

“…Dementia has always been closely related to low educational level. Consequently, in the South there is an evident risk of overestimating cognitive impairment and dementia in subjects still well-functioning in their environment (14,15).…”

“…In a recent study in Southern Italy, Milan et al (15) showed that the cut-off value of the scores on the Mini-Mental State Examination (MMSE) (16) in persons of very low educational level was almost ten points lower than the score conventionally used to detect cognitive impairment. The authors also stated that an environment with "low social demands" may mask the signs of dementia until subjects reach a severe stage of the disease.…”