Evidence map›Paper›PMID 32300635›Full record

ArticleSSM - population health2020

Cognitive impairment in the U.S.: Lifetime risk, age at onset, and years impaired.

Jo Mhairi Hale, Daniel C Schneider, Neil K Mehta, Mikko Myrskylä

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in SSM - population health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 105 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 8 pooled it
8.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 8 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Association between proximity to a lead-releasing facility and cognition in diverse cohorts.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
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  14. Mechanistic signatures of comorbid PTSD with cognitive impairment implicate cortisol-induced neural toxicity.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
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45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 4 countries.

Jo Mhairi HaleUniversity of St Andrews, Scotland, United Kingdom.
Daniel C SchneiderMax Planck Institute for Demographic Research, Rostock, Germany.
Neil K MehtaUniversity of Michigan, MI, USA.
Mikko MyrskyläMax Planck Institute for Demographic Research, Rostock, Germany.
London School of Economics and Political Science · GBMax Planck Institute for Demographic Research · DEUniversity of Michigan–Ann Arbor · USUniversity of St Andrews · GB

Funding

Contribution of Behavioral Factors and Chronic Diseases to International Differences in Healthy Life ExpectancyR03AG060404 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MEHTA, NEIL · 2018 to 2019
$156k
NIA NIH HHS R03 AG060404
6 · The paper itself

Abstract

Prior studies have analyzed the burden of cognitive impairment, but often use potentially biased prevalence-based methods or measure only years lived with impairment, without estimating other relevant metrics. We use the Health and Retirement Study (1998-2014; n = 29,304) and the preferred incidence-based Markov-chain models to assess three key measures of the burden of cognitive impairment: lifetime risk, mean age at onset, and number of years lived impaired. We analyze both mild and severe cognitive impairment (dementia) and gender, racial/ethnic, and educational variation in impairment. Our results paint a multi-dimensional picture of cognitive health, presenting the first comprehensive analysis of the burden of cognitive impairment for the U.S. population age 50 and older. Approximately two out of three Americans experience some level of cognitive impairment at an average age of approximately 70 years. For dementia, lifetime risk for women (men) is 37% (24%) and mean age at onset 83 (79) years. Women can expect to live 4.2 years with mild impairment and 3.2 with dementia, men 3.5 and 1.8 years. A critical finding is that for the most advantaged groups (i.e., White and/or higher educated), cognitive impairment is both delayed and compressed toward the very end of life. In contrast, despite the shorter lives of disadvantaged subgroups (Black and/or lower educated), they experience a younger age of onset, higher lifetime risk, and more years cognitively impaired. For example, men with at least an Associate degree have 21% lifetime dementia risk, compared to 35% among men with less than high school education. White women have 6 years of cognitively-impaired life expectancy, compared to 12 and 13 years among Black women and Latinas. These educational and racial/ethnic gradients highlight the very uneven burden of cognitive impairment. Further research is required to identify the mechanisms driving these disparities in cognitive impairment.

Indexed as

Cognitive impairmentDementiaEducationHealth disparitiesRace/ethnicity

Identifiers

PMID32300635
PMCPMC7153285
OpenAlexW3015112701

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.