Relationships between well‐being and cognitive function among Native American, Black, and White participants in the Wisconsin Alzheimer's Disease Research Center

Abstract

AbstractBackgroundHigh subjective well‐being is a hallmark of successful aging, and growing evidence demonstrates its associations with better cognitive function and slowed decline in aging adults. To date, predominantly white study cohorts preclude an understanding of well‐being as a protective factor in minoritized populations. Using validated NIH Toolbox Emotion Battery measures, we examined associations between three facets of psychological well‐being and cognitive test performance in a cognitively healthy cohort of Black, American Indian/Alaska Native (AI/AN), and white older adults enrolled in the Wisconsin Alzheimer’s Disease Research Center’s (ADRC) Clinical Core.MethodsParticipants with normal cognition and with complete Emotion Battery data for at least one visit were included in the analytic sample. Key well‐being predictors included t‐scores of self‐reported positive affect, general life satisfaction, and life meaning and purpose surveys. Outcomes of interest were performance on tests of processing speed and flexibility (Trails A and B completion time) and episodic memory (Rey Auditory and Verbal Learning Test, Trials 1‐5 & Delayed). The sample was stratified by race before cross‐sectional multivariable regression models were used to model demographic‐adjusted predictor‐outcome relationships.ResultsIn the combined, predominantly female sample, average age was 63.8 (SD=8.3). AI/AN participants (N=25) were older, and Black (N=91) and AI/AN reported fewer years of formal education than their white peers (N=433; Table 1). No racial disparities were observed in positive affect or life purpose scores, but Black and AI/AN participants reported lower life satisfaction. Consistent relationships between life satisfaction and processing speed were observed: across all racial groups, higher t‐scores associated with faster completion time, though estimate precision was limited by small sample sizes (Table 2 and Figure 1).ConclusionsThese ADRC data reaffirm racial disparities in life satisfaction observed elsewhere, which is notable in light of the robust associations of life satisfaction with key components of executive function. Identifying modifiable sources of cognitive resilience and protection against age‐related change is crucial for addressing the dementia crisis and its burden on Black and Native communities. Our findings point to next steps including triangulation with AD biomarkers and exploring population‐specific upstream determinants of life satisfaction that can inform intervention efforts focused on well‐being.