title: Effects of education and race on cognitive decline: An integrative study of generalizability versus study-specific results.
abstract: The objective of the study was to examine variability across multiple prospective cohort studies in level and rate of cognitive decline by race/ethnicity and years of education. We compare data across studies, we harmonized estimates of common latent factors representing overall or general cognitive performance, memory, and executive function derived from the: (a) Washington Heights, Hamilton Heights, Inwood Columbia Aging Project (N = 4,115), (b) Spanish and English Neuropsychological Assessment Scales (N = 525), (c) Duke Memory, Health, and Aging study (N = 578), and (d) Neurocognitive Outcomes of Depression in the Elderly (N = 585). We modeled cognitive change over age for cognitive outcomes by race, education, and study. We adjusted models for sex, dementia status, and study-specific characteristics. The results found that for baseline levels of overall cognitive performance, memory, and executive function, differences in race and education tended to be larger than between-study differences and consistent across studies. This pattern did not hold for rate of cognitive decline: effects of education and race/ethnicity on cognitive change were not consistently observed across studies, and when present were small, with racial/ethnic minorities and those with lower education declining at faster rates. In this diverse set of datasets, non-Hispanic Whites and those with higher education had substantially higher baseline cognitive test scores. However, differences in the rate of cognitive decline by race/ethnicity and education did not follow this pattern. This study suggests that baseline test scores and longitudinal change have different determinants, and future studies to examine similarities and differences of causes of cognitive decline in racially/ethnically and educationally diverse older groups is needed.
authors.affiliation: Department of Epidemiology.
authors.forename: Alden L
authors.initials: AL
authors.lastname: Gross
authors.affiliation: Department of Psychiatry.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Mungas
authors.affiliation: Department of General Internal Medicine.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.affiliation: Department of General Internal Medicine.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Gibbons
authors.affiliation: Department of Neurology.
authors.forename: Anna
authors.initials: A
authors.lastname: MacKay-Brandt
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.affiliation: Department of General Internal Medicine.
authors.forename: Shubhabrata
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Department of Psychiatry and Behavioral Sciences.
authors.forename: Heather
authors.initials: H
authors.lastname: Romero
authors.affiliation: Department of Neurology.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Sachs
authors.affiliation: Department of Psychiatry.
authors.forename: Michael
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of Psychiatry and Behavioral Sciences.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.affiliation: Department of Psychiatry.
authors.forename: Richard N
authors.identifier: 0000-0002-1049-218X
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology / Q000502:physiology / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000208:ethnology / Q000523:psychology*; D004522:Educational Status; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D056344:Executive Function; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D014861:Washington; D044465:White People / Q000523:psychology