Trajectories of cognitive function in late life in the United States: demographic and socioeconomic predictors.
This study used mixed-effects modeling of data from a national sample of 6,476 US adults born before 1924, who were tested 5 times between 1993 and 2002 on word recall, serial 7's, and other mental status items to determine demographic and socioeconomic predictors of trajectories of cognitive function in older Americans. Mean decline with aging in total cognition score (range, 0-35; standard deviation, 6.00) was 4.1 (0.68 standard deviations) per decade (95% confidence interval: 3.8, 4.4) and in recall score (range, 0-20; standard deviation, 3.84) was 2.3 (0.60 standard deviations) per decade (95% confidence interval: 2.1, 2.5). Older cohorts (compared with younger cohorts), women (compared with men), widows/widowers, and those never married (both compared with married individuals) declined faster, and non-Hispanic blacks (compared with non-Hispanic whites) and those in the bottom income quintile (compared with the top quintile) declined slower. Race and income differences in rates of decline were not sufficient to offset larger differences in baseline cognition scores. Educational level was not associated with rate of decline in cognition scores. The authors concluded that ethnic and socioeconomic disparities in cognitive function in older Americans arise primarily from differences in peak cognitive performance achieved earlier in the life course and less from declines in later life.
Karlamangla
Arun S
AS
UCLA Division of Geriatrics, Los Angeles, CA 90095, USA. akarlamangla@mednet.ucla.edu
Miller-Martinez
Dana
D
Aneshensel
Carol S
CS
Seeman
Teresa E
TE
Wight
Richard G
RG
Chodosh
Joshua
J
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003071:Cognition; D016001:Confidence Intervals; D004493:Education / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D017058:Mexican Americans / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data; D012494:Sampling Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data