BACKGROUND: A low level of formal education is becoming accepted as a risk factor for @entity195 ( @entity195 ). Although increasing attention has been paid to differences in educational quality, no previous studies addressed @entity1 ' own characterizations of their overall performance in school. We examined whether self-assessed school performance is associated with @entity195 beyond the effects of educational level alone. METHODS: @entity1 were drawn from the population-representative Aging, Demographics, and Memory Study (ADAMS, 2000-2002). The ADAMS @entity1 were asked about their performance in school. Possible response options included "above average," "average," or "below average." The ADAMS @entity1 also underwent a full neuropsychological battery, and received a research diagnosis of possible or probable @entity195 . RESULTS: The 725 @entity1 (mean age, 81.8 years; 59% female; 16% African-American) varied in self-assessed educational performance: 29% reported "above average," 64% reported "average," and 7% reported "below average" school performance. @entity1 with a lower self-assessed school performance had higher proportions of @entity195 : 11% of @entity1 with "above average" self-assessed performance had @entity195 , as opposed to 12% of @entity1 with "average" performance and 26% of @entity1 with "below average" performance (P < 0.001). After controlling for subjects' years in school, a literacy test score (Wide-Range Achievement Test), age, sex, race/ethnicity, @entity2204 status, socioeconomic status, and self-reported comorbidities, respondents with "below average" self-assessed school performance were four times more likely to have @entity195 compared with those of "average" performance (odds ratio, 4.0; 95% confidence interval, 1.2-14). "Above average" and "average" self-assessed school performance did not increase or decrease the odds of having @entity195 (odds ratio, 0.9; 95% confidence interval, 0.5-1.7). CONCLUSIONS: We suggest an association between "below average" self-assessed school performance and @entity195 beyond the known association with formal education. Efforts to increase cognitive reserve through better school performance, in addition to increasing the number of years of formal education in early life, may be important in reducing vulnerability throughout the life course.

"Below average" self-assessed school performance and XXXX in the Aging, Demographics, and Memory Study.

@entity1 :: ('9606', 'Species') :: ['participants', 'Participants'] @entity2204 :: ('348', 'Gene') :: ['apolipoprotein E-epsilon4'] @entity195 :: ('MESH:D000544', 'Disease') :: ['AD', "Alzheimer's disease"]
@entity195 :: (MESH:D000544,Disease) :: ['Alzheimer's disease']
