ArticleAnnals of epidemiology2021
Stroke Belt birth state and late-life cognition in the Study of Healthy Aging in African Americans (STAR).
Article in Annals of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Living in the United States Stroke Belt and cognitive change in the Women's Health Study: a cohort study.BMC neurology · 2026Observational
- Neuropathology in a diverse cohort of oldest-old: The LifeAfter90 study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Article
- "Rest of the folks are tired and weary": The impact of historical lynchings on biological and cognitive health for older adults racialized as Black.Social science & medicine (1982) · 2025Article
- Childhood Community Disadvantage and MRI-Derived Structural Brain Integrity After Age 65 Years.JAMA network open · 2024Article
- Interpersonal, Community, and Societal Stressors Mediate Black-White Memory Disparities.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Riding the merry-go-round of racial disparities in ADRD research.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Effects of early-life environment and adulthood SES on cognitive change in a multiethnic cohort.Journal of the International Neuropsychological Society : JINS · 2023Article
- The structural and social determinants of Alzheimer's disease related dementias.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Review
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Authors and funding
9 authors.
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Abstract
purposeWe examined the association of Stroke Belt birth state with late-life cognition in The Study of Healthy Aging in African Americans (STAR).
methodsSTAR enrolled 764 Black Americans ages 50+ who were long-term Kaiser Permanente Northern California members. Participants completed Multiphasic Health Check-ups (MHC; 1964-1985) where early-life overweight/obesity, hypertension, diabetes, and hyperlipidemia were measured. At STAR (2018), birth state, self-reported early-life socioeconomic status (SES), and executive function, verbal episodic memory, and semantic memory scores were collected. We used linear regression to examine the association between Stroke Belt birth and late-life cognition adjusting for birth year, gender, and parental education. We evaluated early-life SES and cardiovascular risk factors (CVRF) as potential mechanisms.
resultsTwenty-seven percent of participants were born in the Stroke Belt with a mean age of 69 (standard deviation = 9) at STAR. Stroke Belt birth was associated with worse late-life executive function (β [95% confidence interval]: -0.18 [-0.33, -0.02]) and semantic memory (-0.37 [-0.53, -0.21]), but not verbal episodic memory (-0.04 [-0.20, 0.12]). Adjustment for SES and CVRF attenuated associations of Stroke Belt birth with cognition (executive function [-0.05 {-0.25, 0.14}]; semantic memory [-0.28 {-0.49, -0.07}]).
conclusionsBlack Americans born in the Stroke Belt had worse late-life cognition than those born elsewhere, underscoring the importance of early-life exposures on brain health.
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