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An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States.

ABSTRACT: Objectives: Cognitive aging is a lifelong process with implications for Alzheimer's disease and dementia. This study aims to fill major gaps in research on the natural history of and social disparities in aging-related cognitive decline over the life span. Methods: We conducted integrative data analysis of four large U.S. population-based longitudinal studies of individuals aged 12 to 105 followed over two decades and modeled age trajectories of cognitive function in multiple domains. Results: We found evidence for the onset of cognitive decline in the 4^th decade of life, varying gender differences with age, and persistent disadvantage among non-Hispanic Blacks, Hispanics, and those without college education. We further found improvement in cognitive function across 20^th century birth cohorts but widening social inequalities in more recent cohorts. Discussion: These findings advance an understanding of early life origins of dementia risk and invite future research on strategies for promoting cognitive health for all Americans.

SUBMITTER: Yang YC

PROVIDER: S-EPMC10728348 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States.

Yang Yang C YC Walsh Christine E CE Shartle Kaitlin K Stebbins Rebecca C RC Aiello Allison E AE Belsky Daniel W DW Harris Kathleen Mullan KM Chanti-Ketterl Marianne M Plassman Brenda L BL

Journal of aging and health 20230619 3-4

<b>Objectives:</b> Cognitive aging is a lifelong process with implications for Alzheimer's disease and dementia. This study aims to fill major gaps in research on the natural history of and social disparities in aging-related cognitive decline over the life span. <b>Methods:</b> We conducted integrative data analysis of four large U.S. population-based longitudinal studies of individuals aged 12 to 105 followed over two decades and modeled age trajectories of cognitive function in multiple domai ...[more]

PMID: 37335551

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Project description:BackgroundCognitive reserve (CR) could partly explain the individual heterogeneity in cognitive decline. No study measured CR from a life course perspective and investigated the association between CR and trajectories of cognitive decline in older Chinese adults.MethodsData of 6795 Chinese adults aged 60+ from China Health and Retirement Longitudinal Study were used. Global cognition score (0-32) was assessed in all four waves. A life-course CR score was constructed using markers of childhood circumstance, education, highest occupational class, and leisure activities in later life. Latent growth curve modelling (LGCM) was applied to assess the association between CR and trajectories of cognitive decline.ResultsFor the life-course CR, factor loadings of markers in adulthood and later life were larger than that of markers in childhood. The life-course CR score (ranged between - 2.727 and 6.537, SD: 1.74) was higher in urban Chinese adults (0.75, SD: 1.90) than in rural Chinese adults (- 0.50, SD: 1.43). The unconditional LGCM results showed that urban older Chinese adults had better global cognition at baseline (intercept: 15.010, 95% CI: 14.783, 15.237) and a slower rate of cognitive decline per year (linear slope: -0.394, 95% CI: - 0.508, - 0.281) than their rural counterparts (intercept: 12.144, 95% CI: 11.960, 12.329; linear slope: -0.498, 95% CI: - 0.588, - 0.408). After controlling for all covariates, one-unit higher CR score was associated with 1.615 (95% CI: 1.521, 1.709) and 1.768 (95% CI: 1.659, 1.876) unit higher global cognition at baseline for urban and rural older Chinese adults, respectively. The slower rate of cognitive decline associated with higher CR was more evident in rural residents (slope: 0.083, 95% CI: 0.057, 0.108) than in their urban counterparts (0.054, 95% CI: 0.031, 0.077).ConclusionsCR was associated with better baseline cognition and slower cognitive decline in Chinese older adults. Although rural residents were disadvantaged in both CR and cognition, the protective effect of CR against cognitive decline was stronger for them than in those who live in urban area.

Project description:Epigenetic aging is one plausible mechanism by which socioeconomic status (SES) contributes to disparities in morbidity and mortality. Although the association between SES and epigenetic aging is well documented, the role of parental education into adulthood remains understudied. We examined (1) if parental education was independently associated with epigenetic aging, (2) whether upward educational mobility buffered this association, and (3) if the benefit of parental education was differentiated by race/ethnicity. Secondary data analysis of a subsample (n = 3875) of Non-Hispanic [NH] Black, Hispanic, NH White, and NH other race participants from the Venous Blood Study within Health and Retirement Study were examined. Thirteen clocks based on DNA methylation of cytosine-phosphate-guanine sites were used to calculate epigenetic aging. Participants' education (personal) and their report of their respective parent's education (parental; mother's and/or father's) were included as independent variables; several potential confounders were also included. Direct associations and interactions between parental and personal education were estimated via survey-weighted generalized linear models; marginal means for epigenetic aging were estimated and contrasts were made between the education subcategories. Analyses were also stratified by race/ethnicity. Our results showed that higher parental education was independently associated with slower epigenetic aging among four clocks, whereas higher personal education magnified this association among four different epigenetic clocks. Participants with the lowest parental and personal education had higher marginal means (i.e., accelerated aging) compared to participants with the highest parental and personal education, and there was little evidence of upward mobility. These associations were more frequently observed among NH White participants, whereas fewer were observed for Hispanic and NH Black participants. Overall, our findings support that early-life circumstances may be biologically embedded through epigenetic aging, which may also limit the biological benefits associated with one's own education.

Dataset Information

An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States.

Publications

An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States.

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