Impact of educational attainment on time to cognitive decline among marginalized older adults: Cohort study of 20,311 adults

Abstract

BackgroundThe effect of years of education on the maintenance of healthy cognitive functioning may differ by race and ethnicity given historical and ongoing inequities in educational quality.MethodsWe examined 20,311 Black, Latinx, and White adults aged 51–100 from the Health and Retirement Study (2008–2016). Telephone Interview for Cognitive Status‐27 data was used to measure cognitive functioning. Generalized additive mixed models were stratified by race and ethnicity and educational attainment (≥12 vs. <12 years). Selected social determinants of health, all‐cause mortality, time‐varying health and healthcare utilization characteristics, and study wave were included as covariates.ResultsOn average, Black and Latinx adults scored lower at baseline compared to White adults regardless of educational attainment (p < 0.001), with a significant overlap in the distributions of scores. The rate of cognitive decline was non‐linear for Black, Latinx, and White adults (p < 0.001), and a period of stability was witnessed for those with higher educational attainment irrespective of race and ethnicity. Compared to Black, Latinx, and White adults with lower educational attainment, higher‐educated White adults received the greatest protection from cognitive decline (13 years; 64 vs. 51), followed by Latinx (12 years; 67 vs. 55), and Black adults (10 years; 61 vs. 51). Latinx adults experienced cognitive decline beginning at a later age.ConclusionsThe extent to which higher educational attainment protects adults from cognitive decline differs by race and ethnicity, such that higher‐educated White adults received a greater benefit than higher‐educated Black or Latinx adults.

Impact of Age on Cognitive Testing Practice Effects and Cardiorespiratory Responses

“…This study utilized a 3-week interval between cognitive tests and was conducted in subjects who had completed on average 3 to 4 years of college education. Educational attainment reportedly correlates with cognitive function level ( Wilson et al, 2009 ) and protects older adults from cognitive decline ( Jester et al, 2023 ; Vigoureux et al, 2021 ; Wight et al, 2006 ). It is unclear if the present findings would emerge after shorter or more prolonged test-retest intervals, or if the subjects had represented broader ranges of formal education attainment.…”