). While it is likely that numerous mediating factors (e.g., education, health conditions, and socioeconomic status, etc.) account for the lower performance of African Americans on tests of cognitive ability and functioning, several researchers have noted that such demographic and health factors are infrequently considered in many existing published studies exploring racial group differences in cognition (Whitfield, Fillenbaum, Pieper, Albert, Berkman, Blazer, Rowe, & Seeman, 2000; IzquierdoRorrera & Waldstein, 2002;Zsembik & Peek, 2001). The Role of Education in Cognitive PerformanceOne of the most common general findings in neuropsychological research and gerontological research on cognitive aging has been the major role of education in explaining individual differences in verbal and non-verbal cognition (Schaie, 1996). Studies have indicated that African American adults, on average, are likely to have attained less formal education than European American adults (e.g., Harper & Alexander, 1990), and these differences exist over and above cohort differences in education attainment (Adams-Price, 1993). However, years of education alone has been an inadequate explanation for group differences in cognitive performance; controlling for group differences in educational attainment has generally not explained the lower performance of African American elders on cognitive and neuropsychological measures (Manly et al., 1998;. Several have argued that the "years of education" does not have similar meaning across older racial groups in the United States. This non-equivalence is at least in part due to the historical effects of school segregation in the US prior to 1954, and associated factors like lower education expenditures, shorter school years, and higher student/teacher ratios that were experienced by African American students (Loewenstein, Arguelles, Arguelles, & Linn-Fuentes, 1994;Whitfield & Wiggins, 2003;. Investigators have suggested future research should explore the role of education, both quantitatively and qualitatively, in the epidemiology of cognitive impairment associated with Alzheimer's disease (e.g., Folstein, Anthony, & Parhad, 1985;Whitfield, 2002;Whitfield & Wiggins, 2003). Furthermore, Whitfield (1996, 2002 suggested that studies should examine the practical aspects of cognitive functioning, including performance on measures of everyday problem solving, in the assessment of cognitive status. In general, everyday problem solving measures, by assessing cognition within contextually relevant domains (i.e., medication use, transportation, and other instrumental activities of daily living), have been thought to have more ecological value in determining older adults' daily functioning, than traditional cognitive measures (Allaire & Marsiske, 1999; Willis, 1991). The Role of Education Quality in Understanding Group DifferencesThere have been several studies examining the role of education quality, as approximated by reading achievement, in accounting for racial group differences in cognitive and neuropsych...

These findings suggest that although self-reported cardiovascular health contributes to variability in late life cognition in African Americans, education is a more universal predictor that should be further examined.

The present study investigated evidence for race-related test bias in cognitive measures used in the baseline assessment of the ACTIVE clinical trial. Test bias against African Americans has been documented in both cognitive aging and early lifespan studies. Despite significant mean performance differences, Multiple Indicators Multiple Causes (MIMIC) models suggested most differences were at the construct level. There was little evidence that specific measures put either group at particular advantage or disadvantage and little evidence of cognitive test bias in this sample. Small group differences in education, cognitive status, and health suggest positive selection may have attenuated possible biases.The goal of the present investigation was to examine whether there was evidence of race-related bias in cognitive tests used in a large trial of cognitive interventions with older adults. While much work has been done to examine mean level differences in cognitive performance between racial and ethnic groups (e.g., Manly, Jacobs, Sano, Bell, Merchant, Small, & Stern, 1998;Manly, Jacobs, Touradji, Small, & Stern, 2002;Whitfield, Fillenbaum, Pieper, Albert, Berkman, Blazer, Rowe, & Seeman, 2000), the present investigation extends the current literature by examining the extent to which such differences represent general differences at the level of the cognitive constructs of interest, or whether they also represent test-specific NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript effects (i.e., such that some tests show specific race-group differences above and beyond general group differences at the latent level). Race in this study is operationalized as a comparison between African American and White older adults selected for participation in a cognitive clinical trial. The term African American in this study is used to characterize individuals of African, African American, and African Caribbean descent, while the term White is used to include persons of European descent. Race Differences in Late Life CognitionEvidence from a corpus of studies on the influence of race on late life cognition suggest mean level differences in performance on a variety of cognitive measures between African American and White older adults. Differences, usually in the form of higher performance for Whites, have been reported for tests of intelligence (e.g., Heaton, Ryan, Grant, & Matthews, 1996;Kaufman et al., 1988; Kush, Watkins, Ward, Ward, Canivez, & Worrell, 2001;Vincent, 1991) and for cognitive screening tests/batteries (e.g., Escobar, 1986; Fillenbaum et al., 1990;Inouye, Albert, Mohs, Sun, & Berkman, 1993;Whitfield et al., 2000;Zsembik & Peek, 2001;Manly et al. 1998;Manly et al. 2002; Patton, Duff, Schoenberg, Mold, Scott, Adams, 2003; Unverzagt, Hall, Torke, Rediger, Mercado, Gureje, Osuntokun, & Hendrie,1996). This persistently lower performance by African Americans, which is present throughout the working life span (Avolio & Waldman, 1994), leads to earlier and more frequent cognitive impairment ...

The current study examined predictors of individual differences in the magnitude of practice-related improvements achieved by 87 older adults (meanage 63.52 years) over 18-weeks of cognitive practice. Cognitive inconsistency in both baseline trial-to-trial reaction times and week-to-week accuracy scores was included as predictors of practice-related gains in two measures of processing speed. Conditional growth models revealed that both reaction time and accuracy level and rate-of-change in functioning were related to inconsistency, even after controlling for mean-level, but that increased inconsistency was negatively associated with accuracy versus positively associated with reaction time improvement. Cognitive inconsistency may signal dysregulation in the ability to control cognitive performance or may be indicative of adaptive attempts at functioning.

The United States is undergoing a demographic shift and the health profile of its citizens will largely reflect the health of minorities. African Americans represent the second largest minority group in the United States. This entry describes the health profile of African Americans using key health status indicators, discuss social determinants of health and how interventions might play a critical role in improving the health of African Americans, and conclude with recommendations.