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Objectives In response to the COVID-19 pandemic, older adults are advised to follow social distancing measures to prevent infection. However, such measures may increase the risk of loneliness. The current study aimed to investigate (1) whether social distancing measures, particularly limiting close social interactions, are associated with loneliness among older adults, and (2) whether the association between social distancing measures and loneliness is moderated by sociodemographic characteristics. Methods Data were from the fourth wave (April 29 to May 26, 2020) of the nationally representative Understanding America Study COVID-19 Survey. We used data on adults 50 years or older (N = 3,253). Logistic regression models of loneliness were performed. Five indicators of social distancing measures were considered: (a) avoiding public spaces, gatherings, or crowds, (b) canceling or postponing social activities, (c) social visits, (d) no close contact (within 6 feet) with people living together, and (e) with people not living together. Results Cancelling or postponing social activities and avoiding close contact with people living together were associated with 33% (OR=1.33, CI=1.06−1.68, p < .05) and 47% (OR=1.47, CI=1.09−1.99, p < .05) greater odds of loneliness, respectively. Furthermore, limiting close contact with co-residents increased the probability of loneliness more for males, non-Hispanic Whites, those with higher levels of education and income. Discussion Efforts should be made to help older adults maintain social connectedness with close others by virtual communication methods. Our findings also call special attention to vulnerable groups at elevated risks of loneliness, emphasizing the need for tailored interventions.

Objectives We estimate life expectancy with and without dementia for Americans 65 years and older by education and race to examine how these stratification systems combine to shape disparities in later-life cognitive health. Method Based on the Health and Retirement Study (2000–2014), we use a multivariate, incidence-based life table approach to estimate life expectancy by cognitive health status for race–education groups. The models also simulate group differences in the prevalence of dementia implied by these rates. Results The life table results document notable race–education differences in dementia and dementia-free life expectancy, as well as stark differences in implied dementia prevalence. At each education level, blacks can expect to live more years with dementia and they have significantly higher rates of dementia prevalence. This distribution of disparities in the older population is anchored by 2 groups—blacks without a high school diploma and whites with some college or more. Discussion Dementia experience and dementia burden differ dramatically along race–education lines. Race and education combine to exaggerate disparities and they both have enduring effects. Future research should explicitly consider how race and education combine to influence dementia in the older American population.

Objectives While a number of studies have documented a notable decline in age-standardized prevalence in dementia in the U.S. population, relatively little is known about how dementia has declined for specific age and race groups, and the importance of changing educational attainment on the downward trend. We assess 1) how the trends in dementia prevalence may have differed across age and race groups and 2) the role of changing educational attainment in understanding these trends. Method This paper estimates a series of logistic regression models using data from the Health and Retirement Study (2000-2014) to assess the relative annual decline in dementia prevalence and the importance of improving educational attainment for non-Hispanic Whites and non-Hispanic Blacks. Results Consistent with other studies, we found significant declines in dementia for non-Hispanic Blacks and non-Hispanic Whites across this period. Nonetheless, these declines were not uniform across age and race groups. Non-Hispanic Blacks aged 65-74 had the steepest decline in this period. We also found that improved educational attainment in the population was fundamentally important in understanding declining dementia prevalence in the United States. Discussion This study shows the importance of improvement in educational attainment in the early part of the 20 th century to understand the downward trend in dementia prevalence in the United States from 2000 to 2014.

Objectives Although education is a key determinant of cognitive function, its role in determining Black-White disparities in cognitive function is unclear. This may be due, in part, to data limitations that have made it difficult to account for systemic educational inequities in the Jim Crow South experienced by older cohorts, including differences in the number of days Black students attended school compared to their White counterparts or Black peers in better funded southern states. We determine if accounting for differential rates of school attendance across race, years, and states in the Jim Crow South better illuminates Black-White disparities in trajectories of cognitive function. Methods We linked historical state-level data on school attendance from the 1919/20 to 1953/54 Biennial Surveys of Education to the Health and Retirement Study, a nationally representative, longitudinal study of U.S. adults over age 50. We restricted our sample to Black and White older adults who attended school in the Jim Crow South and began primary school in/after 1919/20 and completed primary/secondary school by 1953/1954 (n=4,343). We used linear mixed models to estimate trajectories of total cognitive function, episodic memory, and working memory. Results Self-reported years of schooling explained 28-33% of the Black-White disparity in level of cognitive function, episodic memory, and working memory. Duration of school, a measure that accounted for differential rates of school attendance, explained 41-55% of the Black-White disparity in these outcomes. Discussion Our study highlights the importance of using a more refined measure of schooling for understanding the education--cognitive health relationship.