State and Local Educational Contexts of Older U.S. Adults and Their Association with Cognitive Impairment and Dementia

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PROJECT SUMMARY Educational attainment, often conceptualized and measured as a human capital attribute, is one of the strongest predictors of Alzheimer’s Disease and related dementias (ADRD) among older adults and perhaps the most important protective factor against cognitive impairment and dementia. Recently documented declines in prevalence and incidence of dementia have been attributed to historical increases in educational attainment. As trends in rising educational attainment slow, it is expected that reductions in the prevalence of ADRD will as well. While it is true that variability in levels of educational attainment has diminished over time, older adults experienced vastly different educational contexts across birth cohorts and by race, particularly Black older adults who grew up in the U.S. South. Consider that from 1920 to 1980, per-pupil spending increased 6-fold, funding allocation became more evenly split between state and local governments, and de jure school segregation was declared unconstitutional. Thus, even if educational attainment remains steady in more recent cohorts, inequities in early life educational contexts may serve to differentiate individuals in their risk for cognitive impairment and dementia. Our project addresses this neglected area of dementia research by addressing four questions: (1) what were the state and local educational contexts experienced by Black and White older adults across birth cohorts; (2) does education operate differently to reduce risk for cognitive impairment or dementia when it is attained under more (or less) advantaged educational contexts among Black and White older adults; (3) do life course pathways encompassing occupation, marriage, behavior, and health explain the relationship between educational contexts and cognitive impairment and dementia and does this vary by educational attainment; and (4) how does state-level variation in the timing of school desegregation efforts and in the extent of court mandated desegregation orders relate to cognitive impairment among Black and White older adults who lived in the U.S. South during school? We will answer these questions through the creation of a rich, longitudinal data resource of state and local educational contexts that we will link to the Health and Retirement Study (HRS), a nationally representative longitudinal study of U.S. adults over 50. We will estimate variation in these relationships by birth cohort and race. Expected outcomes of this study include (a) the development of the Education Contextual Data Resource (ECDR) that we will make available to the scientific community to answer other timely questions about educational contexts and ADRD, significantly expanding the reach of our project’s impact; and (b) insights into broader population trends in ADRD prevalence and racial disparities in ADRD, allowing us to identify the subgroups at greatest risk for cognitive impairment and dementia.