Trajectories of Cognitive Functioning in Later life: Disparities by Race/ ethnicity, Educational Attainment, Sex, and Multimorbidity Combinations
Declaration of sources of funding: This work was supported by the National Institute on Aging at the National Institutes of Health [grant numbers RF1AG058545 to ARQ; R01AG047891 to HGA who contributed from the Yale Claude D. Pepper Older Americans Independence Center P30AG021342 and Yale Alzheimer's Disease Research Center P30AG066508; and P30AG008017, P30AG066518, and P30AG024978 to JK]. The National Health and Aging Trends Study (NHATS) is sponsored by the National Institute on Aging [grant number U01AG032947] through a cooperative agreement with the Johns Hopkins Bloomberg School of Public Health.
Comorbidity, Chronic diseases -- Etiology
Evaluating multimorbidity combinations, racial/ethnic background, educational attainment, and sex associations with age-related cognitive changes is critical to clarifying the health, sociodemographic, and socioeconomic mechanisms associated with cognitive function in later life. Data from the 2011–2018 National Health and Aging Trends Study for respondents aged 65 years and older (N = 10,548, mean age = 77.5) were analyzed using linear mixed effect models. Racial/ethnic differences (mutually-exclusive groups: non-Latino White, non-Latino Black, and Latino) in cognitive trajectories and significant interactions with sex and education (advanced cardiovascularmultimorbidity; metabolic multimorbidity; advanced cardiovascular-metabolic multimorbidity; and neither advanced cardiovascular nor metabolic multimorbidity). In covariate-adjusted models, Black (b = −1.31, 95% CI: 1.74,-0.89) and Latino (b = −0.83, 95% CI: 1.58,-0.07) respondents had lower cognitive scores at age 65 and steeper declines with age (b = −0.08, 95% CI: −0.15,-0.01; b = −0.20, 95% CI: 0.34,-0.05, respectively) compared with White respondents. Cognitive scores were lower among respondents with advanced cardiovascular (b = −0.28, 95% CI: 0.54,-0.01) and advanced cardiovascular-metabolic (b = −0.56, 95% CI: 0.86,-0.27) multimorbidity compared with respondents with none of the chronic diseases of interest. In interaction models, protective associations by female sex and higher education were not observed among minority racial/ethnic groups. It is important to develop interventions to postpone cognitive decline among older Black and Latino adults.
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Quiñones, A. R., Chen, S., Nagel, C. L., Botoseneanu, A., Allore, H. G., Newsom, J. T., ... & Kaye, J. (2022). Trajectories of cognitive functioning in later life: Disparities by race/ethnicity, educational attainment, sex, and multimorbidity combinations. SSM-Population Health, 101084.