title: Deconstructing racial differences: the effects of quality of education and cerebrovascular risk factors.
abstract: OBJECTIVE
  To evaluate the effects of vascular conditions and education quality on cognition over time in White and African American (AA) older adults.
  
  
  METHODS
  We investigated cross-sectional and longitudinal racial differences in executive functioning (EF) and memory composites among Whites (n = 461) and AAs (n = 118) enrolled in a cohort study. We examined whether cerebrovascular risk factors and Shipley Vocabulary scores (a proxy for education quality) accounted for racial differences.
  
  
  RESULTS
  On average, AAs had lower quality of education and more cerebrovascular risk factors including hypertension, diabetes, and obesity. AAs had lower mean EF and memory at baseline, but there were no group differences in rates of decline. Cross-sectional racial differences in EF and memory persisted after controlling for vascular disease, but disappeared when controlling for Shipley Vocabulary.
  
  
  CONCLUSIONS
  Quality of education appears to be more important than cerebrovascular risk factors in explaining cross-sectional differences in memory and EF performance between White and AA older adults. Further investigation is needed regarding the relative contribution of education quality and cerebrovascular risk factors to cognitive decline among ethnically/racially diverse older adults.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island. Department of Psychology, Bridgewater State University, Massachusetts.
authors.forename: Janessa O
authors.initials: JO
authors.lastname: Carvalho
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Doug
authors.initials: D
authors.lastname: Tommet
authors.affiliation: Department of Medicine, University of Washington, Seattle.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Thomas
authors.affiliation: VA Puget Sound Health Care System, Seattle, WA/University of Washington School of Medicine, Seattle.
authors.forename: Amy
authors.initials: A
authors.lastname: Claxton
authors.affiliation: Department of Neurology, Cognitive Neuroscience Division, Columbia University, New York.
authors.forename: Christian
authors.initials: C
authors.lastname: Habeck
authors.affiliation: Department of Neurology, Cognitive Neuroscience Division, Columbia University, New York.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.affiliation: Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Department of Psychiatry, Duke University Medical Center, Durham, North Carolina. Department of Psychology, University of Notre Dame, Indiana. heather.romero@duke.edu.
authors.forename: Heather R
authors.initials: HR
authors.lastname: Romero
mesh_terms: D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000208:ethnology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009657:North Carolina / Q000208:ethnology; D012307:Risk Factors; D014825:Vocabulary; D044465:White People / Q000208:ethnology*
keywords: African American; Cognitive decline; Education quality; Latent growth curve modeling; Race; Vascular
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