Education and Cognitive Decline: An Integrative Analysis of Global Longitudinal Studies of Cognitive Aging

Sean A P CloustonPhD, Dylan M SmithPhD, Soumyadeep MukherjeePhD, Yun ZhangMmed, Wei HouPhD, Bruce G LinkPhD, Marcus RichardsPhD and J Scott BrownPhD

The Journals of Gerontology: Series B, 2020, vol. 75, issue 7, e151-e160

Abstract: BackgroundThe objective of this study was to examine the association between education and incidence of accelerated cognitive decline.MethodsSecondary analyses of data from the Health and Retirement Study (HRS), a nationally representative prospective cohort study of U.S. residents were conducted (N = 28,417). Cox proportional hazards survival models were layered on longitudinal mixed-effects modeling to jointly examine healthy cognitive aging and incidence of accelerated cognitive decline consistent with patterns seen in preclinical Alzheimer’s disease and related dementias (ADRD). Replication analyses were completed on a database including 62,485 additional respondents from HRS sister studies. Life expectancy ratios (LER) and 95% confidence intervals (CIs) were reported.ResultsThis study replicated research showing that education was positively associated with cognition at baseline. Model fit improved using the survival method compared to random-slopes models alone. Analyses of HRS data revealed that higher education was associated with delayed onset of accelerated cognitive decline (LER = 1.031 95% CI = [1.013–1.015], p

Keywords: Alzheimer’s disease; Cognitive aging; Cognitive decline; Cognitive reserve; Education; Fundamental Cause Theory; Layered longitudinal modeling (search for similar items in EconPapers)
Date: 2020
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