TY - JOUR T1 - Educational Benefits and Cognitive Health Life Expectancies: Racial/Ethnic, Nativity, and Gender Disparities JF - The Gerontologist Y1 - 2021 A1 - Marc Garcia A1 - Brian Downer A1 - Chi-Tsun Chiu A1 - Joseph L Saenz A1 - Ortiz, Kasim A1 - Rebeca Wong KW - cognitive impairment KW - Dementia KW - Life Expectancy KW - nativity KW - Race/ethnicity AB - To examine racial/ethnic, nativity, and gender differences in the benefits of educational attainment on cognitive life expectancies among older adults in the United States.We used data from the Health and Retirement Study (1998-2014) to estimate Sullivan-based life tables of cognitively healthy, cognitively impaired/no dementia (CIND), and dementia life expectancies by gender for older White, Black, U.S.-born and foreign-born Hispanic adults with less than high school, high school, and some college or more.White respondents lived a greater percentage of their remaining lives cognitive healthy than their minority Black or Hispanic counterparts, regardless of level of education. Among respondents with some college or more, versus less than high school, Black and U.S.-born Hispanic women exhibited the greatest increase (both 37 percentage points higher) in the proportion of total life expectancy spent cognitively healthy; whereas White women had the smallest increase (17 percentage points higher). For men, the difference between respondents with some college or more, versus less than high school, was greatest for Black men (35 percentage points higher) and was lowest for U.S.-born Hispanic men (21 percentage points higher).Our results provide evidence that the benefits of education on cognitive life expectancies are largest for Black men and women, and U.S.-born Hispanic women. The combination of extended longevity and rising prevalence of Alzheimer’s disease point to the need for understanding why certain individuals spend an extended period of their lives with poor cognitive health. VL - 61 SN - 0016-9013 IS - 3 ER - TY - JOUR T1 - Racial/Ethnic and Nativity Differences in Cognitive Life Expectancies Among Older Adults in the United States. JF - Gerontologist Y1 - 2018 A1 - Marc Garcia A1 - Brian Downer A1 - Chi-Tsun Chiu A1 - Joseph L Saenz A1 - Rote, Sunshine A1 - Rebeca Wong KW - Cognitive Ability KW - Dementia KW - Mortality KW - Racial/ethnic differences AB -

Background and Objectives: To document racial/ethnic and nativity differences by gender in cognitive life expectancies among older adults in the United States.

Research Design and Methods: Sullivan-based life tables were used to estimate cognitively normal, cognitively impaired/no dementia (CIND), and dementia life expectancies by gender for White, Black, U.S.-born Hispanic, and foreign-born Hispanic adults 50 years and older in the Health and Retirement Study.

Results: Among women, the number of years spent living with dementia for Whites, Blacks, U.S.-born Hispanics, and foreign-born Hispanics was 1.6, 3.9, 4.7, and 6.0 years, respectively. For men, Whites lived 1.1 years with dementia compared to 3.1 years for Blacks, 3.0 years for U.S.-born Hispanics and 3.2 years for foreign-born Hispanics. Similar patterns were observed for race/ethnic and nativity differences in CIND life expectancies. Blacks and Hispanics spend a larger fraction of their remaining years with CIND and dementia relative to Whites, regardless of gender. Foreign-born Hispanic men and women and Black men are particularly disadvantaged in the proportion of years spent after age 50 with CIND and/or dementia.

Discussion and Implications: Disparities in cognitive life expectancies indicate that intervention strategies should target the specific needs of minority and immigrant older adults with dementia. Given that education is a strong predictor of cognitive health, improving access to the social and economic resources that delay dementia onset is key to improving the well-being of diverse older adults.

VL - 38 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28958071?dopt=Abstract ER - TY - JOUR T1 - Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability? JF - Population Research and Policy Review Y1 - 2014 A1 - Mark D Hayward A1 - Robert A Hummer A1 - Chi-Tsun Chiu A1 - César González-González A1 - Rebeca Wong KW - Demographics KW - Disabilities KW - Health Conditions and Status KW - Women and Minorities AB - Studies consistently document a Hispanic paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born. PB - 33 VL - 33 UR - http://dx.doi.org/10.1007/s11113-013-9312-7 IS - 1 U4 - Hispanic paradox/Disability/Disability/Mortality/Disabled life expectancy/Nativity ER -