Race/ethnic differences in cognitive decline: Results from the health and retirement study

TitleRace/ethnic differences in cognitive decline: Results from the health and retirement study
Publication TypeJournal Article
Year of Publication2008
AuthorsMehta, KM, Barnes, LL, Thorpe, Jr., RJ, Perez-Stable, EJ, Covinsky, KE, Yaffe, K
JournalAlzheimer's and dementia : the journal of the Alzheimer's Association
KeywordsHealth Conditions and Status

Background: As the minority population and dementia prevalence are rapidly growing, understanding cognitive decline in racially diverse elders is an increasingly important public health issue. Our goal was to evaluate whether cognitive decline occur at an accelerated rate for persons of non-White race/ethnicity (African American, Latino) compared to White older adults. Methods: Participants were from the US-representative Health and Retirement Study (HRS) 1998-2004. Cognitive assessment consisted of immediate and delayed free recall as well as serial 7s test, orientation, and naming for a total score of 35 points. Our primary outcomes were biennial cognitive change from 1998 to 2004 and cognitive decline defined as 5 point decline from 1998 to 2004. We calculated change in cognition, odds of cognitive decline, and evaluated mediators by race/ethnic group using mixed effects regression and logistic regression models. Results: The 5,552 HRS participants (mean age 72 6 years, 60 Female, 10 African Amercan, 6 Latino) had an average cognitive decline of 2.1 4.3 points over the 6 year study period. Overall, 33 of African Americans declined, 28 of Latinos declined and 26 of Whites declined. After controlling for age, gender, educational level in years, socioeconomic factors (total net worth and current income), self-reported medical comorbidity (self reported medical history of hypertension, heart disease, diabetes and stroke), and baseline cognition, African Americans were more likely to decline compared to Whites (OR 2.2; 95 CI 1.7-2.7). Latino older adults were similar to Whites in odds of cognitive decline (OR Latino 1.3; 95 CI 0.9-1.7). Conclusions: African American adults aged 65 and above were more likely to experience cognitive decline compared to White older adults after accounting for demographics, socioeconomics, comorbidity, and their baseline cognitive function. There was no difference between Latino older adults and Whites in rates of cognitive decline. Future research to identify ways to reduce cognitive decline, particularly for racially-diverse groups, are needed.

Endnote Keywords

Dementia/Cognitive decline/COMORBIDITY

Endnote ID


Citation Key7286