Sherman-Wilkins Kyler J, Thierry Amy D
Department of Sociology and Anthropology, Missouri State University, Springfield, MO 65897, USA.
Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA.
Geriatrics (Basel). 2019 Sep 5;4(3):51. doi: 10.3390/geriatrics4030051.
Though evidence suggests that the prevalence of cognitive impairment has declined, there still exists a disproportionate burden of ill cognitive health for people of color. In this paper, we test two alternative mechanisms to explain the interactive effect of education and race/ethnicity on cognitive impairment risk: the minority poverty and diminishing returns hypotheses. Drawing on data from the 2012 wave of the Health and Retirement Study (HRS) ( 8093), we estimate logistic regression models to determine differential effects of education on cognitive impairment. We find that non-Hispanic black and Mexican American older adults have higher odds of being cognitively impaired compared to whites, though the ethnic difference (whites vs. Mexican Americans) is mediated by education. Further, we find that while high levels of education are protective against cognitive impairment at older ages, it is more protective for non-Hispanic blacks than for whites and more protective for whites than Mexican Americans. Lastly, we find that racial/ethnic disparities are widest at lower levels of education, consistent with the minority poverty hypothesis. We conclude that the results herein highlight the importance of attending to how factors that are protective for cognitive functioning (e.g., education) may operate differently across racial and ethnic groups.
尽管有证据表明认知障碍的患病率有所下降,但有色人种在认知健康不良方面的负担仍然过重。在本文中,我们检验了两种替代机制,以解释教育与种族/族裔对认知障碍风险的交互作用:少数族裔贫困假说和收益递减假说。利用2012年健康与退休研究(HRS)(8093)的数据,我们估计了逻辑回归模型,以确定教育对认知障碍的不同影响。我们发现,与白人相比,非西班牙裔黑人和墨西哥裔美国老年人认知受损的几率更高,不过种族差异(白人 vs. 墨西哥裔美国人)受教育程度的影响。此外,我们发现,虽然高水平的教育对老年人的认知障碍有保护作用,但对非西班牙裔黑人的保护作用比对白人更大,对白人的保护作用比对墨西哥裔美国人更大。最后,我们发现种族/族裔差异在低教育水平时最为明显,这与少数族裔贫困假说一致。我们得出结论,本文的结果凸显了关注对认知功能有保护作用的因素(如教育)在不同种族和族裔群体中可能存在不同作用方式的重要性。