School of Health Professions, University of Texas Medical Branch at Galveston, Galveston, TX 77555-1137, USA.
Ann Epidemiol. 2009 Nov;19(11):778-83. doi: 10.1016/j.annepidem.2009.06.008. Epub 2009 Aug 5.
Minority group membership in old age has been implicated as a risk factor for lower scores on cognitive function tests, independent of education level. In addition, differential rates of cognitive decline by ethnic group have been identified in several epidemiologic studies. However, others have not been able to detect differences.
In order to determine if health disparities in cognitive function scores extend to rates of decline, the current research examined rates of change in memory and mental status over the course of 9 years (1996-2004) in a nationally representative sample of late middle-aged and older white, black, and Hispanic adults who were part of the nationally representative Health and Retirement Study. Change in cognitive function was measured by separate indices of memory and mental status items and analyzed with multivariable mixed modeling.
Results indicated that, after controlling for demographic, social, and health-related variables, ethnicity was associated with cognitive function scores across waves (P<0.01), but did not greatly impact rates of decline. Furthermore, although education was associated with cognitive function scores across waves (P<0.01), education level did not impact decline rates.
Some health disparities in cognitive function exist even in late middle age, but ethnic differences in rates of decline are mixed.
少数群体在老年时的成员身份被认为是认知功能测试得分较低的一个风险因素，而与教育水平无关。此外，在几项流行病学研究中已经确定了不同种族群体认知能力下降的差异率。然而，其他人却无法发现差异。
为了确定认知功能评分中的健康差异是否扩展到下降速度，本研究在一个全国代表性的中老年白种人、黑人和西班牙裔成年人样本中，检查了 9 年（1996-2004 年）期间记忆和心理状态的变化率，这些成年人是全国代表性健康和退休研究的一部分。认知功能的变化通过记忆和心理状态项目的单独指数进行衡量，并使用多变量混合模型进行分析。
结果表明，在控制人口统计学、社会和健康相关变量后，种族与各波次的认知功能评分相关（P<0.01），但对下降速度影响不大。此外，尽管教育与各波次的认知功能评分相关（P<0.01），但教育水平对下降速度没有影响。
即使在中老年时期，认知功能也存在一些健康差异，但下降速度的种族差异是混杂的。
