Department of Psychiatry, University of Michigan Medical School, Ann Arbor.
Institute for Social Research, Ann Arbor.
J Gerontol B Psychol Sci Soc Sci. 2019 Feb 15;74(3):536-545. doi: 10.1093/geronb/gbw210.
Recent interest has been generated about reports of declining incidence in cognitive impairment among more recently born cohorts. At the same time, attained education, which is related to cognition, has increased in recent cohorts of older adults. We examined cohort differences in cognitive function in a nationally representative sample of Americans aged 25 and older followed for 25 years (1986-2011) and considered the extent to which cohort differences in education account for differences.
Data come from the Americans' Changing Lives Study (N = 3,617). Multiple cohort latent growth models model trajectories of cognition (errors on the Short Portable Mental Status Questionnaire) across four 15-year birth cohorts. Demographic factors, educational attainment, and time-varying health conditions were covariates.
Significant cohort differences were found in the mean number of cognitive errors (e.g., 0.26 more errors at age 65 in cohort born pre-1932 vs cohort born 1947-1961, p < .001). Although demographic and health conditions were associated with level and rate of change in cognitive dysfunction, education solely accounted for cohort differences.
Compression of cognitive morbidity is seen among the highly educated, and increasing educational opportunities may be an important strategy for decreasing the risk for cognitive impairment in later life.
最近，人们对出生较晚的人群认知障碍发病率下降的报告产生了兴趣。与此同时，与认知相关的受教育程度在老年人群的最近几代中有所增加。我们在一个具有全国代表性的 25 岁及以上美国人样本中研究了认知功能的队列差异，这些人在 25 年内（1986-2011 年）接受了随访，并考虑了教育程度的队列差异在多大程度上造成了差异。
数据来自美国人生活变化研究（N=3617）。多个队列潜在增长模型模拟了四个 15 年出生队列的认知轨迹（在简短便携式精神状态问卷上的错误）。人口统计学因素、教育程度和随时间变化的健康状况是协变量。
在认知错误的平均数量上发现了显著的队列差异（例如，在 65 岁时，出生于 1932 年之前的队列比出生于 1947-1961 年的队列多 0.26 个错误，p<.001）。尽管人口统计学和健康状况与认知功能障碍的水平和变化率有关，但教育程度仅解释了队列差异。
在受教育程度较高的人群中，认知发病的压缩现象明显，增加教育机会可能是降低晚年认知障碍风险的重要策略。
