Educational inequalities in aging-related declines in fluid cognition and the onset of cognitive pathology

TitleEducational inequalities in aging-related declines in fluid cognition and the onset of cognitive pathology
Publication TypeJournal Article
Year of Publication2015
AuthorsClouston, SAP, Glymour, MM, Terrera, GMuñiz
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
KeywordsDemographics, Health Conditions and Status

Background: Education has been robustly associated with cognitive reserve and dementia, but not with the rate of cognitive aging, resulting in some confusion about the mechanisms of cognitive aging. This study uses longitudinal data to differentiate between trajectories indicative of healthy versus pathologic cognitive aging. Methods: Participants included 9401 Health and Retirement Study respondents aged 55 years who completed cognitive testing regularly over 17.3 years until most recently in 2012. Individual-specific random change-point modeling was used to identify age of incident pathologic decline; acceleration is interpreted as indicating likely onset of pathologic decline when it is significant and negative. Results: These methods detect incident dementia diagnoses with specificity/sensitivity of 89.3 /44.3 , 5.6 years before diagnosis. Each year of education was associated with 0.09 (95 confidence interval CI , 0.087-0.096; P .001) standard deviation higher baseline cognition and delayed onset of cognitive pathology (hazard ratio, 0.98; 95 CI, 0.96-0.99; P = .006). Conclusions: Longitudinal random change-point modeling was able to reliably identify incident dementia. Accounting for incident cognitive pathology, we find that education predicts cognitive capability and delayed onset pathologic declines. 2015 The Authors.


Export Date: 9 September 2015

Endnote Keywords

Aging/Cognitive reserve/Dementia/Educational status/Neurology/Social medicine

Endnote ID


Citation Key8169
PubMed ID26309906
PubMed Central IDPMC4542007