Recent Improvements in Cognitive Functioning Among Older U.S. Adults: How Much Does Increasing Educational Attainment Explain?
Recent interest has been generated about reports of declining incidence in cognitive impairment among more recently born cohorts. At the same time, attained education, which is related to cognition, has increased in recent cohorts of older adults. We examined cohort differences in cognitive function in a nationally representative sample of Americans aged 25 and older followed for 25 years (1986-2011) and considered the extent to which cohort differences in education account for differences.



Data come from the Americans' Changing Lives Study (N = 3,617). Multiple cohort latent growth models model trajectories of cognition (errors on the Short Portable Mental Status Questionnaire) across four 15-year birth cohorts. Demographic factors, educational attainment, and time-varying health conditions were covariates.



Significant cohort differences were found in the mean number of cognitive errors (e.g., 0.26 more errors at age 65 in cohort born pre-1932 vs cohort born 1947-1961, p < .001). Although demographic and health conditions were associated with level and rate of change in cognitive dysfunction, education solely accounted for cohort differences.



Compression of cognitive morbidity is seen among the highly educated, and increasing educational opportunities may be an important strategy for decreasing the risk for cognitive impairment in later life.
Department of Psychiatry, University of Michigan Medical School, Ann Arbor.
Amanda
A
Leggett
Institute for Social Research, Ann Arbor.|Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor.
Philippa
P
Clarke
Department of Psychiatry, University of Michigan Medical School, Ann Arbor.|Institute for Healthcare Policy and Innovation, Ann Arbor.|Institute for Social Research, Ann Arbor.|Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan.|Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor.
Kara
K
Zivin
Division of General Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor.
Ryan J
RJ
McCammon
Institute for Social Research, Ann Arbor.|Biostatistics Department, University of Michigan School of Public Health, Ann Arbor.
Michael R
MR
Elliott
Institute for Healthcare Policy and Innovation, Ann Arbor.|Institute for Social Research, Ann Arbor.|Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan.|Division of General Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor.
Kenneth M
KM
Langa
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged; D012923:Social Class; D011795:Surveys and Questionnaires
Cognition; cognitive impairment; cohort differences; education