Impact of educational attainment on time to cognitive decline among marginalized older adults: Cohort study of 20,311 adults.

TitleImpact of educational attainment on time to cognitive decline among marginalized older adults: Cohort study of 20,311 adults.
Publication TypeJournal Article
Year of Publication2023
AuthorsJester, DJ, Palmer, BW, Thomas, ML, Brown, LL, Tibiriçá, L, Jeste, DV, Gilmer, T
JournalJ Am Geriatr Soc
ISSN Number1532-5415
Abstract

BACKGROUND: The effect of years of education on the maintenance of healthy cognitive functioning may differ by race and ethnicity given historical and ongoing inequities in educational quality.

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p>METHODS: We examined 20,311 Black, Latinx, and White adults aged 51-100 from the Health and Retirement Study (2008-2016). Telephone Interview for Cognitive Status-27 data was used to measure cognitive functioning. Generalized additive mixed models were stratified by race and ethnicity and educational attainment (≥12 vs. <12 years). Selected social determinants of health, all-cause mortality, time-varying health and healthcare utilization characteristics, and study wave were included as covariates.

RESULTS: On average, Black and Latinx adults scored lower at baseline compared to White adults regardless of educational attainment (p < 0.001), with a significant overlap in the distributions of scores. The rate of cognitive decline was non-linear for Black, Latinx, and White adults (p < 0.001), and a period of stability was witnessed for those with higher educational attainment irrespective of race and ethnicity. Compared to Black, Latinx, and White adults with lower educational attainment, higher-educated White adults received the greatest protection from cognitive decline (13 years; 64 vs. 51), followed by Latinx (12 years; 67 vs. 55), and Black adults (10 years; 61 vs. 51). Latinx adults experienced cognitive decline beginning at a later age.

CONCLUSIONS: The extent to which higher educational attainment protects adults from cognitive decline differs by race and ethnicity, such that higher-educated White adults received a greater benefit than higher-educated Black or Latinx adults.

DOI10.1111/jgs.18340
Citation Key13263
PubMed ID37073606
Grant ListR01 MH120201 / MH / NIMH NIH HHS / United States
T32 MH019934 / MH / NIMH NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States
T32MH019934 / MH / NIMH NIH HHS / United States