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Smaller Head Circumference Combined with Lower Education Predicts High Risk of Incident Dementia: The Shanghai Aging Study

Fei Wang,J. Mortimer,D. Ding,Jianfeng Luo,Qianhua Zhao,Xiaoniu Liang,Wanqing Wu,Li Zheng,Q. Guo,A. Borenstein,Z. Hong

Published 2019 in Neuroepidemiology

ABSTRACT

Introduction: An important index of brain reserve is the maximal attained brain size, which can be estimated by measuring the head circumference (HC). We investigated the association of HC and education with incident dementia in a population-based study of Chinese older adults. Methods: We conducted a prospective follow-up study of 1,659 non-demented participants with a mean age of 71.5 years. Characteristics and anthropometry of the participants were collected at baseline. Consensus diagnoses for dementia were made using DSM-IV criteria based on functional, neurological, and neuropsychological assessments. Results: We identified 168 new-onset dementia cases after a mean of 5.2 years of follow-up. Participants with smaller HC combined with low educational attainment had a significantly higher risk of incident dementia than those with larger HC who had completed more than 12 years of education (adjusted hazard ratio 4.48, 95% CI 2.47–8.12). Discussion/Conclusion: Our results suggest that smaller HC in combination with low education leads to a markedly increased risk of dementia.

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