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. 2025 Feb;21(2):e14410.
doi: 10.1002/alz.14410. Epub 2024 Dec 18.

Early life exposure to structural sexism and late-life memory trajectories among black and white women and men in the United States

Justina F Avila-Rieger  1   2   3 , Paris B Adkins-Jackson  4   5 , Tanisha G Hill-Jarrett  6   7   8 , Whitney R Robinson  9 , Katherine M Keyes  4 , Nicole Schupf  1   2   3 , Adam M Brickman  1   2   3 , Richard P Mayeux  1   2   3 , Jennifer J Manly  1   2   3
Affiliations

Early life exposure to structural sexism and late-life memory trajectories among black and white women and men in the United States

Justina F Avila-Rieger et al. Alzheimers Dement. 2025 Feb.

Abstract

Introduction: We investigated whether early life exposure to state-level structural sexism influenced late-life memory trajectories among United Staes (U.S.) -born women and men and determined whether associations differed between racialized groups.

Methods: Participants were from the Washington Heights-Inwood Columbia Aging Project (WHICAP; N = 2314) and Health and Retirement Study (HRS; N = 18,631). State-level structural sexism was measured via U.S. census and administrative data and linked to participants in each study by birth year and state.

Results: Exposure to greater structural sexism was associated with lower baseline memory performance among WHICAP women and HRS men and faster memory decline among women in both studies. Women born in the state with the highest structural sexism showed memory decline like that of those who were 9 years older. Structural sexism-baseline memory associations were stronger among Black women than White women.

Discussion: Early life exposure to structural sexism negatively impacts late-life memory trajectories among women.

Highlights: A longitudinal measure captured state-level structural sexism from 1900 to 1960. Exposure to structural sexism was associated with worse late-life memory outcomes. Associations were strongest among women for memory decline. The negative impact on memory performance was stronger among Black women. Lowering structural sexism may, in turn, reduce memory decline among women.

Keywords: intersectionality; memory decline; sex/gender; structural sexism.

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Conflict of interest statement

None. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Structural sexism factor scores by state and year from 1900 to 1960. Factor scores were generated for each decennial and intercensal year between 1900 and 1960 using a two‐level time series analysis with a first‐order autoregressive confirmatory factor analysis.
FIGURE 2
FIGURE 2
Predicted memory trajectories at low and high levels of structural sexism across racialized groups, sex/gender, and study. Figure 2 plots predictions from Model 2 for individuals at ± 1 SD from the overall mean of structural sexism in the United States between 1900 and 1960. The x‐axis represents the years since the participants’ baseline visit, and the y‐axis represents the corresponding predicted memory score. The figure shows that, in both studies, associations between structural sexism and baseline memory performance were stronger among Black women compared with White women. Women in both studies also showed stronger structural sexism‐memory decline associations compared with men.
See this image and copyright information in PMC

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