Explaining Differences in Episodic Memory Performance among Older African Americans and Whites: The Roles of Factors Related to Cognitive Reserve and Test Bias

Fyffe, Denise; Mukherjee, Shubhabrata; Barnes, Lisa L.; Manly, Jennifer J.; Bennett, David A.; Crane, Paul K.

doi:10.1017/s1355617711000476

Cited by 56 publications

(48 citation statements)

References 76 publications

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“…Future studies with longitudinal measures of brain structure may offer insights underlying racial disparities in hippocampal sizes and other factors associated with cognitive reserve. 17 Overall, diagnostic performance of CSF biomarkers was universally lower among African American compared with white participants. Accounting for demographic characteristics and other factors lowered these disparities but did not totally account for them.…”

Section: Discussionmentioning

confidence: 94%

“…Covariate adjustments were performed on potential factors that may affect or confound racial disparity in AD risk and cognitive performance, including age, sex, educational level, body mass index (BMI; calculated as weight in kilograms divided by square of height in meters), and family history of AD. We included MoCA scores in the multivariate models to potentially account for the difference in cognitive reserve by race 17 and account for the possibility that biomarker differences are a result of the different stages of disease within the cognitively impaired group. Hippocampal volume comparisons were further adjusted for the estimated intracranial volume.…”

Section: Discussionmentioning

confidence: 99%

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Racial Disparity in Cerebrospinal Fluid Amyloid and Tau Biomarkers and Associated Cutoffs for Mild Cognitive Impairment

et al. 2019

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IMPORTANCE Prior evidence suggests that racial differences exist in tau biomarkers in mild cognitive impairment (MCI) and Alzheimer disease (AD). Whether this reported disparity is associated with a differential level of neurodegeneration and disease stage or with underlying mechanisms separate from amyloid or tau is unclear. OBJECTIVES To compare cerebrospinal fluid (CSF) biomarkers in African American and white individuals with normal cognition and MCI, to estimate race-based cutoffs for these biomarkers that maximize diagnostic discrimination between normal cognition and MCI, and to study the association of demographic characteristics, cognitive performance, and common vascular risk factors with these differences.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Racial Disparity in Cerebrospinal Fluid Amyloid and Tau Biomarkers and Associated Cutoffs for Mild Cognitive Impairment

et al. 2019

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“…Episodic memory, the ability to learn and retain new information, was assessed via 7 tests including immediate and delayed recall of story A from Logical Memory of the Weschler Memory Scale (Weschler, 1987), immediate and delayed recall of the East Boston Story (Albert et al, 1991), Word List Memory, Word List Recall, and Word List Recognition (Morris et al, 1989), as done in prior work (Albert et al, 1991; Dong et al, 2010; Fyffe et al, 2011; Wilson et al, 2002). Raw scores on all 7 tests were converted to z-scores using the mean and standard deviation of the cohort at baseline and averaged to create a composite measure of episodic memory (Wilson, Bienias, Berry-Kravis, Evans, & Bennett, 2002; Wilson et al, 2002).…”

Section: Methodsmentioning

confidence: 99%

Cognitive decline impairs financial and health literacy among community-based older persons without dementia.

Boyle¹,

Yu²,

Wilson³

et al. 2013

Psychology and Aging

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113

122

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Literacy is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory), and b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. 645 community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those assessed in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n=447) persons with repeated cognitive assessments available for up to 14 years, regression analysis supported the association of multiple resources with literacy; moreover, more rapid declines in executive function and episodic memory over an average of 6.4 years prior to the literacy assessment predicted lower literacy scores (p’s<0.02), but rate of decline in word knowledge did not. These findings suggest that diverse individual resources contribute to financial and health literacy and lower literacy in old age is partially due to declines in executive function and episodic memory.

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“…1 and 2 Non-Hispanic blacks (blacks hereafter) are more likely to have a positive AD diagnosis and tend to perform more poorly on cognitive function tests compared to non-Hispanic whites (whites hereafter). 3 and 4 Although reasons for these disparities are poorly understood, several explanations have been provided in the literature, including: racial differences in years or quality of education 5 or reading level, 6 lack of social resources for blacks, 7 higher cognitive reserve among whites, 8 and better cognition-preserving activities among whites over their lifespan. 9 …”

Section: Introductionmentioning

confidence: 99%

Physical and Cognitive Activities as Deterrents of Cognitive Decline in a Biracial Population Sample

Rajan

Barnes

Skarupski

et al. 2015

The American Journal of Geriatric Psychiatry

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Objective Physical and cognitive activities are associated with slower cognitive decline. However, few studies have examined racial differences in these associations. Methods Data came from a longitudinal study of 7742 (63% black and 61% female) participants assessed 3 times over an average of 9.5 years. At baseline, each participant reported number of hours of leisure time physical activity (categorized using quartiles) and rated frequency of participation in cognitively stimulating activities (range: 0 – 4). A standardized measure of cognition was derived from tests of memory, perceptual speed, and orientation. Results Of the 7742 participants, 2322 (30%) reported no physical activity. Cognitive decline was slower by about 20% (95% confidence interval: 13 – 27%) among whites with physical activity above 1.25 hours compared to those with no physical activity, but showed no significant decrease in cognitive decline relative to those with no physical activity among blacks. Further post-hoc analysis revealed cognitive decline to be slower by about 29% (95% CI: 20 – 38%) among blacks and whites with higher education and above average baseline cognition. A 1-point increase in cognitive activity frequency decreased cognitive decline by 8% (95% CI: 3 – 14%) among blacks and by 14% (95% CI: 7 – 20%) among whites. Conclusions The benefits of higher physical activity on cognitive decline was observed among whites, and among blacks with higher education and above average baseline cognitive function. However, the protective effect of cognitive activity seems to be independent of education and baseline cognitive function among both blacks and whites.

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Explaining Differences in Episodic Memory Performance among Older African Americans and Whites: The Roles of Factors Related to Cognitive Reserve and Test Bias

Cited by 56 publications

References 76 publications

Racial Disparity in Cerebrospinal Fluid Amyloid and Tau Biomarkers and Associated Cutoffs for Mild Cognitive Impairment

Racial Disparity in Cerebrospinal Fluid Amyloid and Tau Biomarkers and Associated Cutoffs for Mild Cognitive Impairment

Cognitive decline impairs financial and health literacy among community-based older persons without dementia.

Physical and Cognitive Activities as Deterrents of Cognitive Decline in a Biracial Population Sample

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