Causal Effects of Education on Elder Cognitive Decline

教育对老年人认知能力下降的因果影响

• 批准号: 6804720
• 负责人: LISA F BERKMAN
• 金额: $ 20.5万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6804720
• 关键词: aging; alcoholic beverage consumption; behavioral /social science research tag; body physical activity; cardiovascular disorder; clinical research; cognition disorders; education; health behavior; human mortality; human old age (65+); longitudinal human study; questionnaires; smoking; tobacco abuse

DESCRIPTION (provided by applicant): We propose to examine the relationship between education and cognitive decline and mortality in old age using longitudinal data from the Health and Retirement Survey (HRS). Although the correlation between education and cognitive decline is well-documented, it is not known if this relationship is causal or due to confounding by individual characteristics such as cognitive ability or family economic status. Furthermore, if we assume this relationship is causal, the key mediators are unknown. We emphasize the importance of innovative analytic approaches in estimating the overall causal effect and in testing specific pathways. Our primary aims are: 1) to derive consistent estimates of the causal effect of education on cognitive change and mortality using instrumental variables analysis; 2) to test whether the effect of education on cognitive outcomes operates through a latency, social trajectory, or cumulative harm model; and 3) to provide unbiased estimates of the importance of three hypothesized pathways linking education and cognitive decline, using new analytic approaches emphasizing the time-varying nature of both mediators and confounders. These hypothesized pathways are: social ties, health behaviors, and cardiovascular health. Rapid changes in state educational policies influenced the educational attainment of birth cohorts in the first half of the 20 th century. Using such natural experiments, instrumental variables analyses can provide estimates of health effects of education, even when important confounders are unmeasured. State policy data on instruments such as compulsory schooling and term length, will be linked to individual level data from the Health and Retirement Survey (HRS). As of the 2002 interview wave, the combined HRS sample included 1 to 5 waves of memory and mental status assessments on over 25,000 participants.We will use innovative methods to test specific pathways while accounting for time-varying covariates. HRS contains detailed information on lifecourse socioeconomic position, including 40 years of Social Security earnings information on over 9,000 original sample members, and physical and behavioral characteristics assessed at up to 6 interview waves. We distinguish between alternative models of how adult socioeconomic trajectories may mediate the effect of education on cognitive decline. Finally, we use gestimation to examine the importance of social ties, health behaviors, and cardiovascular risk in mediating the effect of education on cognitive outcomes.

描述（由申请人提供）：我们建议使用健康和退休调查（HRS）的纵向数据检查教育与老年人认知能力下降与死亡率之间的关系。尽管教育与认知能力下降之间的相关性有充分的文献记录，但尚不清楚这种关系是因果关系还是由于个人特征（例如认知能力或家庭经济状况）的混淆。此外，如果我们认为这种关系是因果关系，那么关键的中介者是未知的。我们强调创新分析方法在估计总体因果效应和测试特定途径中的重要性。我们的主要目的是：1）通过工具变量分析得出教育对认知变化和死亡率的因果关系的一致估计； 2）测试教育对认知结果的影响是否通过潜伏期，社会轨迹或累积伤害模型运作； 3）使用新的分析方法强调了调解人和混杂因素的时变性质，以提供三种假设途径和认知能力下降的假设途径的重要性。这些假设的途径是：社会关系，健康行为和心血管健康。国家教育政策的快速变化影响了20世纪上半叶出生队列的教育成就。使用这样的自然实验，即使重要的混杂因素无法测量，仪器变量分析也可以提供教育健康影响的估计。有关强制性教育和期限长度等工具的国家政策数据将与健康与退休调查（HRS）中的个人级别数据相关联。截至2002年的访谈浪潮，合并后的人力资源样本包括对超过25,000名参与者的1至5波的记忆和心理状态评估。我们将使用创新的方法来测试特定途径，同时考虑时间变化的协变量。 HRS包含有关生命性社会经济地位的详细信息，其中包括40年的社会保障收入信息，这些信息有关9,000多个原始样本成员以及最多6个面试浪潮评估的身体和行为特征。我们区分成人社会经济轨迹如何介导教育对认知能力下降的影响的替代模型。最后，我们使用盖斯蒂姆研究社会关系，健康行为和心血管风险在调解教育对认知结果的影响方面的重要性。