High School and Beyond: Cohort Data for Studying the Effects of Education on Midlife Cognition

Abstract

AbstractBackgroundThe objective of our presentation is to describe the utility of data from the High School and Beyond (HSB) cohort for studying the impact of early life circumstances and experiences—especially related to education—on risk of midlife cognitive impairment. HSB is a cohort study of a large (n∼25,500), diverse, nationally‐representative probability sample of American high school students in 1980. Participants were surveyed in 1980, 1982, 1984, 1986, 1992, and 2014/2015 with high rates of response; teachers and school administrators were also surveyed, and transcripts provide information about secondary and postsecondary course taking. HSB data from 1980 through 1992 include detailed information about educational contexts, opportunities, and outcomes as well as about family circumstances, labor force activities, and other early life factors.MethodA 2021/2022 follow‐up survey with surviving cohort members featured lengthy interviews; a home health visit that included blood and saliva collection and anthropometric measures; and linkages to administrative records (e.g., mortality records, prescription records). Interviews included immediate and delayed recall tasks; a phonemic fluency task; a semantic fluency task; working memory tasks; self‐reported memory complaints; and detailed information about health conditions.ResultOf the ∼24,330 surviving HSB panelists, ∼13,900 completed surveys in 2021/2022. Of the ∼13,900 sample members completing surveys, ∼4,880 completed a home health visit; an additional ∼1,560 mailed back saliva kits. HSB ultimately received ∼4,430 blood samples by the time fieldwork concluded in late 2022. Blood collected in 2022 is being used to construct (1) measures that define the main pathological features of ADRD (e.g., Aβ42, Aβ40, p‐tau 181, total tau, NFL, and gFAP); (2) measures that reflect cognition‐relevant pathologies (e.g., hemoglobin A1c, inflammatory markers, markers of endothelial function, markers of blood‐brain barrier disfunction, and blood lead levels); and (3) measures of biological aging (e.g., the GrimAge clock, DunedinPACE pace of aging, the Hannum clock).ConclusionHSB is now an extraordinary resource for studying—using a large, diverse national sample—the effects of educational contexts, opportunities, and outcomes on midlife cognitive functioning and biological markers of ADRD risk.