The featured paper is ‘Religious education and midlife observance are associated with dementia three decades later in Israeli men’. This is a cohort study which has been examined at three points (including the current study) over a length period of time (three decades). The authors begin by hypothesising that the strict lifestyle of Orthodox Jews would lead to a lower prevalence of dementia in later life in a cohort of people in the Israeli Ischaemic Heart Disease Study (IIHD) who were selected in 1963. The IIHD involved a selection of 11,876 civil servants and employees. Of these people, 2604 (25.9%) were alive in 1999 and a further 2038 (78.3%) of these participated in a telephone survey. Participants were administered the Hebrew version of the Modified Telephone Interview for Cognitive Status. Those who scored above 27 were assessed in person and a number of tests including the Dementia Questionnaire, Hachinski Ischemic Scale and MMSE were administered as part of a clinical assessment. A diagnosis of Dementia was based on a DSM-IV assessment. In 1963, administered questionnaires contained questions on type of religious education and midlife religious practice examples of which included a group called ‘Haredim’ who keep a very strict lifestyle, an agnostic group as well as a number of other groups. There were a number of physical measures including BP and an assessment of diabetes in three visits in the initial phase of the study (during the 1960’s) as these are confounders when looking at dementia.
The researchers found that 27.1% of those with ‘exclusively religious education’ had dementia whist the figures were 12.6% for those with mixed education and 16.1% for those with a secular education. These groups were compared to each other using a logistic regression analysis and after controlling for 3 sociodemographic variables didn’t significantly alter these findings. There was a trend for an increase in rate of dementia with an increase in the extent of a person’s religious practice (i.e. midlife observance). The authors suggest a number of reasons for these findings including genetic susceptibility in subgroups to Alzheimer’s, characteristics of migrant populations within the sample, differences between self-reporting and actual practice as well as speculation on the role of rote memorisation in education as opposed to techniques such as vocabulary elaboration for which there is evidence of protection against dementia.
One potential confounder which was mentioned in the introduction but I couldn’t find in the discussion was the exercise which might be worth looking at in future studies. This study however throws up some important findings and perhaps further studies will clarify the nature of the relationship between religious practice and dementia and develop appropriate preventative interventions.
Michal Beeri, Michael Davidson, Jeremy Silverman, James Schmeidler, Ramit Springer, Shlomo Noy and Uri Goldbourt. Religious education and midlife observance are associated with dementia three decades later in Israeli men. Journal of Clinical Epidemiology. 61. 2008. 1161-1168.
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