How Childhood State Education Quality Shapes the Risk of Cognitive Impairment in Mid-to-Later Life.

INTRODUCTION: Education is a key predictor of cognitive impairment, yet most research focuses on educational attainment rather than educational quality as an early-life determinant.

METHODS: We linked data from the 2000-2020 Health and Retirement Study to historical records on state public education systems. Using multinomial logistic regression, we examined whether state-level education quality in childhood-measured by funding sources and educational resources-was associated with the incidence of cognitive impairment, with or without dementia, among Black and White adults aged 55 and older.

RESULTS: White adults who grew up in states with more heavily state-funded education systems had an increased risk of cognitive impairment. Greater state-level educational resources were associated with a decreased risk of cognitive impairment among both White and Black adults. Associations did not differ by race.

CONCLUSION: State-level educational quality is an important determinant of later-life cognitive impairment risk for White and Black adults.