RACE/ETHNICITY, EDUCATION & LATE LIFE COGNITIVE FUNCTION

在有关痴呆症或认知障碍的研究中，高龄、受教育程度和种族/民族始终与认知不良有关。在已发表的文献中，有重要证据质疑跨种族/民族和教育程度群体的认知状态评估的结构效度。对于观察到的不同种族/民族和受教育程度群体之间认知状况和其他健康结果之间关系的差异，有一个非常合理的解释：在评估这些群体的认知功能时存在系统测量误差（项目偏差）。本研究的目的是通过基于项目反应理论（IRT）的项目偏差评估来研究这一假设。数据将从非常古老的美国大陆居民的概率样本中获得。具体而言，(1)来自最老老人的资产和健康动态（AHEAD）数据集的认知评估数据将用于拟合IRT模型，以适应来自美国高龄居民样本的修正电话访谈的认知状态反应，(2)将进行项目偏差分析，以检验零假设，即在保持潜在认知能力不变的组间差异的同时，项目(a)不存在种族/民族偏见；(b)不因受教育程度而有偏见。进一步(3)由于种族/民族受教育程度而导致的整体认知能力和系统测量误差的群体差异的证据将根据AHEAD数据集中存在的丰富的社会人口和社会经济指标进行评估。本研究通过探索受教育程度、年龄、社会经济地位和种族/民族如何影响项目层面的认知评估，在理解晚年认知功能方面取得了重大进展。这项工作的结果将(1)为继续开发文化公平的认知评估工具提供信息，(2)促进对认知评估中种族/民族和教育影响的理解，(3)将有助于解释认知与其他健康状况测量和认知衰退和痴呆的可疑风险因素之间关系的种族/民族差异。

Advanced age, level of educational attainment and race/ethnicity are consistently associated with poor cognition in studies concerning dementing disorders or cognitive impairments. Important evidence in the published literature questions the construct validity of cognitive status assessment across race/ethnicity and educational attainment groups. There is a very plausible explanation for observed differences in the relationship of cognitive status and other health outcomes across race/ethnicity and educational attainment groups: systematic measurement error (item bias) in the assessment of cognitive functioning across these groups. The aim of this proposal is to investigate this hypothesis by conducting an item response theory (IRT) based item bias evaluation of cognitive assessments of very old persons. Data will be obtained from a probability sample of very old continental U.S. residents. Specifically, (l) cognitive assessment data from the Asset and Health Dynamics of the Oldest Old (AHEAD) data set will be used to fit an IRT model to modified Telephone Interview for Cognitive Status responses from a sample of very old U.S. residents, and (2) item bias analyses will be conducted testing null hypotheses that, while holding constant group differences in underlying cognitive ability, the items are (a) free from bias according to race/ethnicity, and (b) free from bias according to level of educational attainment. Further (3) evidence of group differences in overall cognitive ability and systematic measurement error due to level of race/ethnicity educational attainment will be evaluated conditional on the rich array of sociodemographic and socioeconomic indicators present in the AHEAD data set. The proposed analysis represents a significant advance in the understanding of late life cognitive functioning by exploring how educational attainment, age, socioeconomic status and race/ethnicity affect cognitive assessment at the item level. Results from this work will (l) inform continuing efforts to develop culture fair cognitive assessment instruments, (2) promote understanding of race/ethnicity and education effects in cognitive assessment, and (3) will help explain race/ethnicity differences in the relation of cognition to other health status measures and suspected risk factors for cognitive decline and dementia.