Racial differences in cognitive decline in a sample of community-dwelling older adults: the mediating role of education and literacy

Abstract

Objective: The authors examined racial differences in cognitive decline (CD) and the role of education and literacy in mediating this relationship.

Methods: The relationship between race and CD was examined over a 3-year period in a biracial community sample of older adults (N = 3,097) living in North Carolina.

Results: African Americans, as compared with White participants, had fewer years of education and were more likely to be assessed by the interviewer as not literate. Race predicted CD such that African Americans had higher rates than Whites. When education and literacy were entered into the analysis, the association between race and CD, although remaining statistically significant, was reduced and was of relatively weak magnitude. Also, physical functioning problems also predicted CD and were found to be greater in African Americans than in Whites.

Conclusions: Education and literacy may be protective factors against CD. Socioeconomic disadvantages experienced by older African Americans in the South early in life, leading to poorer educational opportunities, may explain, in part, the increased rates of CD in older African Americans versus Whites.