Post‐secondary Education as a Modifiable Risk for Dementia: Birth Cohort and Gender Findings from the Health and Retirement Study

Abstract

AbstractBackgroundEducation and gender are well‐known predictors of cognitive functioning after age 60, but multiple mechanisms underlie these associations. Research on dementia prevalence in the United States has highlighted the importance of considering historical changes in the quantity (years) of childhood education in potentially delaying diagnosis. Less attention has been given to gender differences in post‐secondary education despite considerable increases since the 1970s in the completion of university degrees by women.MethodWe examined new data for two cohorts of men and women in the Health and Retirement Study (HRS) about the types and content (field of study) of their college degrees. College information was collected in a Life History Mail Survey (2015‐2017). Cognitive status was assessed on a 27‐point scale in tests conducted in contingent biennial interviews (2016, 2018). Test scores were classified to indicate normal function, cognitive impairment (MCI / CIND) or dementia based on the validated HRS Langa‐Weir algorithm. The analytic sample of 9213 (60% women; 40% men) with complete data included individuals born before 1948 (n = 4662; mean age at cognitive test = 79; age range 69‐107) and Baby Boomers born 1948 to 1959 (n = 4551; mean age at cognitive test = 62).ResultsAs expected, compared to the older cohorts, more Baby Boomers had post‐secondary education (44% vs 52%; p <.001). Men in the older cohort were more likely to have a Bachelor or higher‐level degree than women, but gender was not a significant predictor of degree type in the Baby Boomers. Cohort disaggregated analyses predicting cognitive function revealed that having a BA/BSc degree provided more protection against cognitive impairment for Baby Boomer women than for men with the same degree (p < .001). College majors were gendered and significantly accounted for variance in late‐life cognitive status depending on specialization.ConclusionsThe birth cohort and gender disparities in post‐secondary education revealed in our analyses provide new insight into modifiable aspects of education beyond childhood. Future research should consider the quality and timing of college education and subsequent employment histories as life course factors that differentiate trajectories of cognitive aging and transition to dementia.