@article {11396, title = {The Importance of Improving Educational Attainment for Dementia Prevalence Trends from 2000-2014, among Older non-Hispanic Black and White Americans.}, journal = {The Journals of Gerontology, Series B}, volume = {76}, year = {2021}, pages = {1870-1879}, abstract = {

OBJECTIVES: While a number of studies have documented a notable decline in age-standardized prevalence in dementia in the U.S. population, relatively little is known about how dementia has declined for specific age and race groups, and the importance of changing educational attainment on the downward trend. We assess 1) how the trends in dementia prevalence may have differed across age and race groups and 2) the role of changing educational attainment in understanding these trends.

METHOD: This paper estimates a series of logistic regression models using data from the Health and Retirement Study (2000-2014) to assess the relative annual decline in dementia prevalence and the importance of improving educational attainment for non-Hispanic Whites and non-Hispanic Blacks.

RESULTS: Consistent with other studies, we found significant declines in dementia for non-Hispanic Blacks and non-Hispanic Whites across this period. Nonetheless, these declines were not uniform across age and race groups. Non-Hispanic Blacks aged 65-74 had the steepest decline in this period. We also found that improved educational attainment in the population was fundamentally important in understanding declining dementia prevalence in the United States.

DISCUSSION: This study shows the importance of improvement in educational attainment in the early part of the 20 th century to understand the downward trend in dementia prevalence in the United States from 2000 to 2014.

}, keywords = {Cognitive health, Educational attainment}, issn = {1758-5368}, doi = {10.1093/geronb/gbab015}, author = {Mark D Hayward and Mateo P Farina and Yuan S Zhang and Jung K Kim and Eileen M. Crimmins} } @article {11421, title = {Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000-2010.}, journal = {The Journals of Gerontology, Series B}, volume = {76}, year = {2021}, pages = {319-329}, abstract = {

OBJECTIVES: To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less-educated white Americans during the first decade of the twenty-first century.

METHODS: This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (i) change in age-specific mortality rates; and (ii) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL).

RESULTS: Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. In contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less-educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages.

DISCUSSION: Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less-educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

}, keywords = {Disability, Education, Healthy life expectancy, Mortality}, issn = {1758-5368}, doi = {10.1093/geronb/gbz145}, author = {Cantu, Phillip A and Connor M Sheehan and Sasson, Isaac and Mark D Hayward} }