The association between educational parameters and a cognitive screening measure in older blacks

State-Level Education Quality and Trajectories of Cognitive Function by Race and Educational Attainment

Policy Points Education-cognition research overlooks the role of education quality in shaping cognitive function at midlife and older ages, even though quality may be more responsive to federal and state investment in public schooling than attainment. For older US adults who attended school during the early to mid-20th century, the quality of US education improved considerably as federal and state investment increased. Ensuring access to high-quality primary and secondary education may protect against poor cognitive function at midlife and older ages, particularly among Black Americans and persons who complete less education. It may also play an important role in reducing health inequities.

CONTEXT

Although educational attainment is consistently associated with better cognitive function among older adults, we know little about how education quality is related to cognitive function. This is a key gap in the literature given that the quality of US education improved considerably during the early to mid-20th century as state and federal investment increased. We posit that growing up in states with higher-quality education systems may protect against poor cognitive function, particularly among Black adults and adults who completed fewer years of school.

METHODS

We used prospective data on cognitive function from the Health and Retirement Study linked to historical data on state investment in public schools, restricting our sample to non-Hispanic White and Black adults born between 1914 and 1959 (19,096 White adults and 4,625 Black adults). Using race-stratified linear mixed models, we considered if state-level education quality was associated with level and decline in cognitive function and if these patterns differed by years of schooling and race.

FINDINGS

Residing in states with higher-resourced education systems during childhood was associated with better cognitive function, particularly among those who completed less than 12 years of schooling, regardless of race. For White adults, higher-resourced state education systems were associated with higher scores of total cognitive function and episodic memory, but there were diminishing returns as resources increased to very high levels. For Black adults, the relationship between state education resources and cognitive function varied by age with positive associations in midlife and generally null or negative associations at the oldest ages.

CONCLUSIONS

Federal and state investment in public schools may provide students with opportunities to develop important cognitive resources during schooling that translate into better cognitive function in later life, especially among marginalized populations.

Literacy Level and Executive Control in Healthy Older Peruvian Adults

Introduction: Early-life educational experiences are associated with cognitive performance in aging. Early literacy seems to improve executive control mechanisms, however, it is not clear whether early education would still be an advantage in countries like Peru, where access to and quality of education is highly variable.

Aim: Our objective was to analyze the association of literacy level with executive control factors.

Method: We evaluated 93 healthy older adults with a clinical protocol that included the Mini-Mental State Examination, the Geriatric Depression Scale and Global Dementia Staging. We also used a neuropsychological executive function battery which included the Trail-Making Test parts A and B, the Stroop Test, phonological and semantic verbal fluency tasks, Forward and Backward Digits, Numbers and Letters of the Wechsler Scale, and the Go/No-Go task. We used a principal component analysis for the dimensional reduction of the variables. To measure the level of literacy we used the word accentuation test (WAT).

Results: We observed statistically significant correlations between the principal components (PCs) of working memory, cognitive flexibility and inhibitory control with the WAT scores. Furthermore, we observed that processing speed and WAT predict the scores on PCs factors better than years of education and age.

Conclusions: Literacy level correlates more closely with better cognitive performance than years of education and thus, might improve executive control factors that could compensate and protect against brain changes in cognitive decline and dementia.

School Context in Adolescence and Cognitive Functioning 50 Years Later

To advance understanding of how social inequalities from childhood might contribute to cognitive aging, we examined the extent to which school context in adolescence was associated with individuals' cognitive performance more than 50 years later. Using data from 3,012 participants in the Wisconsin Longitudinal Study (WLS), we created an aggregate measure of school-level structural advantage, with indicators such as the proportion of teachers who had at least five years of teaching experience and spending per pupil. Multilevel models indicated that secondary school advantage was associated with small benefits in language/executive function at age 65 among older adults who had lower academic achievement in secondary school. Findings suggest that school advantage is a developmental context of adolescence that has modest implications for intracohort differences in aspects of later life cognition.