Gross Alden L, Mungas Dan M, Crane Paul K, Gibbons Laura E, MacKay-Brandt Anna, Manly Jennifer J, Mukherjee Shubhabrata, Romero Heather, Sachs Bonnie, Thomas Michael, Potter Guy G, Jones Richard N
Department of Epidemiology.
Department of Psychiatry.
Psychol Aging. 2015 Dec;30(4):863-880. doi: 10.1037/pag0000032. Epub 2015 Nov 2.
The objective of the study was to examine variability across multiple prospective cohort studies in level and rate of cognitive decline by race/ethnicity and years of education. We compare data across studies, we harmonized estimates of common latent factors representing overall or general cognitive performance, memory, and executive function derived from the: (a) Washington Heights, Hamilton Heights, Inwood Columbia Aging Project (N = 4,115), (b) Spanish and English Neuropsychological Assessment Scales (N = 525), (c) Duke Memory, Health, and Aging study (N = 578), and (d) Neurocognitive Outcomes of Depression in the Elderly (N = 585). We modeled cognitive change over age for cognitive outcomes by race, education, and study. We adjusted models for sex, dementia status, and study-specific characteristics. The results found that for baseline levels of overall cognitive performance, memory, and executive function, differences in race and education tended to be larger than between-study differences and consistent across studies. This pattern did not hold for rate of cognitive decline: effects of education and race/ethnicity on cognitive change were not consistently observed across studies, and when present were small, with racial/ethnic minorities and those with lower education declining at faster rates. In this diverse set of datasets, non-Hispanic Whites and those with higher education had substantially higher baseline cognitive test scores. However, differences in the rate of cognitive decline by race/ethnicity and education did not follow this pattern. This study suggests that baseline test scores and longitudinal change have different determinants, and future studies to examine similarities and differences of causes of cognitive decline in racially/ethnically and educationally diverse older groups is needed.
本研究的目的是通过种族/族裔和受教育年限来检验多个前瞻性队列研究中认知衰退水平和速率的变异性。我们对各项研究的数据进行了比较，对代表整体或一般认知表现、记忆和执行功能的共同潜在因素的估计值进行了协调，这些因素源自：(a) 华盛顿高地、汉密尔顿高地、因伍德哥伦比亚衰老项目（N = 4115），(b) 西班牙文和英文神经心理学评估量表（N = 525），(c) 杜克记忆、健康与衰老研究（N = 578），以及 (d) 老年人抑郁症的神经认知结局（N = 585）。我们针对认知结局，按种族、教育程度和研究对随年龄的认知变化进行了建模。我们对模型进行了性别、痴呆状态和研究特定特征的调整。结果发现，对于整体认知表现、记忆和执行功能的基线水平，种族和教育程度的差异往往大于研究间的差异，且在各项研究中保持一致。这种模式在认知衰退速率方面并不成立：教育程度和种族/族裔对认知变化的影响在各项研究中并非始终一致，即便存在影响，其效应也较小，种族/族裔少数群体和受教育程度较低者的衰退速率更快。在这组多样的数据集中，非西班牙裔白人以及受教育程度较高者的基线认知测试分数显著更高。然而，按种族/族裔和教育程度划分的认知衰退速率差异并不遵循这一模式。本研究表明，基线测试分数和纵向变化具有不同的决定因素，未来需要开展研究，以检验种族/族裔和教育程度各异的老年群体中认知衰退原因的异同。
