Occupational position and complexity in relation to Black-White cognitive disparities.

INTRODUCTION

Occupational characteristics are less commonly measured social determinants of health that may contribute to racial dementia disparities. We assessed whether occupational position (OP) or complexity (OC) mediated racial cognitive disparities.

METHODS

Participants were Black and White older adults from the Michigan Cognitive Aging Project (MCAP) (n = 536; M = 63.64 ± 3.07; 59% women; 53% Black). We assessed whether OP (six US Census categories) or OC (mental/social/physical demands) mediated cognitive disparities. Sequential mediation analyses assessed whether OP explained cognitive disparities through OC, income, and/or wealth.

RESULTS

Black participants had low (vs high) OP, which predicted worse episodic memory and global cognition (4% to 7% mediated). OC did not mediate cognitive disparities. Disparities in cognition operated through inequities in OP, education, and income. Effects were driven by participants not currently working.

DISCUSSION

Occupation may influence cognitive disparities primarily through socioeconomic, rather than cognitive stimulation, pathways. Policies targeting workforce inequities may reduce racial disparities in dementia risk.

HIGHLIGHTS

OP mediated 4% to 7% of racial cognitive disparities. OC did not uniquely mediate racial cognitive disparities. Sequential mediation highlighted life course socioeconomic pathways of disparities. Socioeconomic factors more strongly relate to cognitive disparities than engagement. Findings were driven by participants who were not currently in the workforce.