In the U.S., older black adults face almost twice the risk of Alzheimer’s dementia as their white counterparts. Now, a new study led by a Boston University School of Public Health researcher confirms this gap and suggests it is due to disparities in education.
The study, published in Epidemiology, found similar rates of cognitive decline in black and white participants, but black participants scored substantially lower on average in the study’s cognitive tests than white participants of the same age; the performance gap was equivalent to the performance gap between participants 12 years apart in age. When the researchers modeled a scenario where all participants had had 16 years of formal education, the racial disparity in cognitive function fell by more than 50 percent, and the disparity in Alzheimer’s risk fell by nearly 40 percent.
“One of the strongest determinants of cognitive level is educational attainment,” says lead author Dr. Jennifer Weuve, associate professor of epidemiology at BU. The researchers found black participants had completed an average of two fewer years of formal education than white participants.
“Education, unlike race, is modifiable,” Dr. Weuve says.
The study used the cohort from the Chicago Health and Aging Project (CHAP), which has followed a total of 10,802 individuals 65 years old or older living on the south side of Chicago since 1993. Participants were interviewed and their cognitive function tested in three-year cycles, and a sample also underwent clinical evaluation for Alzheimer’s dementia. A total of 441 participants have developed Alzheimer’s, with an “extra” 58 cases per 1,000 every three years among black participants compared to their white counterparts, the authors wrote.
Because education is influenced by social policy, the authors said, improving access and reducing inequities in education could be a potent strategy to reduce Alzheimer’s dementia risk at the population level, as well as reduce racial disparities in cognitive well-being.
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