ArticleAlzheimer disease and associated disorders
Parental Education, Midlife Hypertension, and Disparities in Late-Life Cognitive Test Scores: Application of an Equity-Focused Causal Decomposition Approach.
Article in Alzheimer disease and associated disorders. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundParental education is an important determinant of late-life cognition, but the extent to which intervening on midlife risk factors, such as hypertension, mitigates the impact of early-life factors is unclear. Novel methodological approaches, such as causal decomposition, facilitate the assessment of contributors to health inequities through hypothetical interventions on mediating risk factors.
methodsUsing harmonized cohorts (Kaiser Healthy Aging and Diverse Life Experiences Study; Study of Healthy Aging in African Americans) and a ratio of mediator probability weights decomposition approach, we quantified disparities in late-life cognitive test scores (semantic memory, executive function, and verbal memory z -scores) across high versus low parental education, and evaluated whether socioeconomic disparities in late-life cognitive test scores would change if the corresponding disparity in midlife hypertension were eliminated.
resultsWe observed substantial disparities across levels of parental education in late-life cognitive test scores (eg, =-0.72 95% CI: -0.84 to -0.60 for semantic memory). Hypothetical intervention on midlife hypertension did not substantially reduce disparities in any cognitive domain. Patterns were similar when stratified by race.
conclusionsFuture work should evaluate other points of intervention across the lifecourse (eg, participant education) to reduce late-life cognitive disparities across levels of parental education.
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