Min Hee Kim, Sze Yan Liu, Willa D Brenowitz, Audrey R Murchland, Thu T Nguyen, Jennifer J Manly, Virginia J Howard, Marilyn D Thomas, Tanisha Hill-Jarrett, Michael Crowe, Charles F Murchison, M Maria Glymour
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引用次数: 0
Abstract
Background: Education is strongly associated with cognitive outcomes at older ages, yet the extent to which these associations reflect causal effects remains uncertain due to potential confounding.
Methods: Leveraging changes in historical measures of state-level education policies as natural experiments, we estimated the effects of educational attainment on cognitive performance over 10 years in 20,248 non-Hispanic Black and non-Hispanic White participants, aged 45+ in the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort (2003-2020) by (1) using state- and year- specific compulsory schooling laws, school-term length, attendance rate, and student-teacher ratio policies to predict educational attainment for US Census microsample data from 1980 and 1990, and (2) applying policy-predicted years of education (PPYEd) to predict memory, verbal fluency, and a cognitive composite. We estimated overall and race- and sex-specific effects of PPYEd on level and change in each cognitive outcome using random intercept and slope models, adjusting for age, year of first cognitive assessment, and indicators for state of residence at age 6.
Results: Each year of PPYEd was associated with higher baseline cognition (0.11 standard deviation [SD] increase in composite measure for each year of PPYEd, 95% confidence interval [CI]: 0.07, 0.15). Subanalyses focusing on individual cognitive domains estimate the largest effects of PPYEd on memory. PPYEd was not associated with rate of change in cognitive scores. Estimates were similar across Black and White participants and across sex.
Conclusions: Historical policies shaping educational attainment are associated with better later life memory, a major determinant of dementia risk.
期刊介绍：
Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.
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