Trajectories of Cognitive Function in Late Life in the United States: Demographic and Socioeconomic Predictors
Trajectories of Cognitive Function in Late Life in the United States: Demographic and Socioeconomic Predictors
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DOI：
10.1093/aje/kwp154
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发表时间：
2009-08-01
影响因子：
5
通讯作者：
Chodosh, Joshua
中科院分区：
文献类型：
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作者：
Karlamangla, Arun S.;Miller-Martinez, Dana;Chodosh, Joshua
这项研究使用了来自1924年之前出生的6，476名美国成年人的全国样本的混合效应模型，这些成年人在1993年至2002年期间接受了5次关于单词回忆，连续7和其他精神状态项目的测试，以确定美国老年人认知功能轨迹的人口统计学和社会经济学预测因素。总认知评分随年龄增长平均下降（范围，0-35;标准差，6.00）为4.1（0.68标准差）/十年（95%置信区间：3.8，4.4）和回忆分数（范围，0-20;标准差，3.84）为2.3（0.60标准差）每十年（95%置信区间：2.1，2.5）。老年人（与年轻人相比）、女性（与男性相比）、寡妇/鳏夫和未婚者（与已婚者相比）下降得更快，非西班牙裔黑人（与非西班牙裔白人相比）和收入最低的五分之一人群（与收入最高的五分之一人群相比）下降得更慢。下降率的种族和收入差异不足以抵消基线认知评分的较大差异。教育水平与认知得分的下降率无关。作者得出结论，美国老年人认知功能的种族和社会经济差异主要来自生命早期达到的峰值认知表现的差异，而不是晚年的衰退。
This study used mixed-effects modeling of data from a national sample of 6,476 US adults born before 1924, who were tested 5 times between 1993 and 2002 on word recall, serial 7's, and other mental status items to determine demographic and socioeconomic predictors of trajectories of cognitive function in older Americans. Mean decline with aging in total cognition score (range, 0-35; standard deviation, 6.00) was 4.1 (0.68 standard deviations) per decade (95% confidence interval: 3.8, 4.4) and in recall score (range, 0-20; standard deviation, 3.84) was 2.3 (0.60 standard deviations) per decade (95% confidence interval: 2.1, 2.5). Older cohorts (compared with younger cohorts), women (compared with men), widows/widowers, and those never married (both compared with married individuals) declined faster, and non-Hispanic blacks (compared with non-Hispanic whites) and those in the bottom income quintile (compared with the top quintile) declined slower. Race and income differences in rates of decline were not sufficient to offset larger differences in baseline cognition scores. Educational level was not associated with rate of decline in cognition scores. The authors concluded that ethnic and socioeconomic disparities in cognitive function in older Americans arise primarily from differences in peak cognitive performance achieved earlier in the life course and less from declines in later life.