Race, Psychiatric History, and Cognitive Function in Later Life

Race, Psychiatric History, and Cognitive Function in Later Life

Abstract

Purpose: Advocates of the life course perspective suggest that cumulative (dis)advantage affects cognitive function in later life. Because psychiatric conditions are more prevalent among disadvantaged groups such as racial/ethnic minorities, who are also at risk of experiencing cognitive decline in later life, it is important to explore the relationship between race/ethnicity, psychiatric history, and cognitive function. Few studies examine these relationships, and studies employing nationally representative datasets to examine factors influencing cognitive function in later life are rarely longitudinal in design, do not employ multiple waves of data, or do not analyze the relationships between these particular factors. This study explores the following hypotheses:

1.         Individuals with a longer-term history of psychiatric, emotional or nervous problems will have lower cognition scores at age 65 and will experience different rates of cognitive decline as they age, net the effects of ascribed demographic characteristics, early childhood status, and later life sociodemographic factors, health status and health behaviors;

2.         The relationship between longer-term psychiatric history and cognitive function in later life affects people differently based on ascribed characteristics. The effect of this relationship may be greater for Hispanics and non-Hispanic Blacks than for Whites, net the effects of sex, early childhood status, and later life characteristics.

Methods: This study explores these relationships using data from six waves of the Health and Retirement Study (HRS). Growth curve models are used to analyze the data, controlling for sex, early childhood health and disadvantage, later life demographics, and health behavior and health status variables.

Results: Findings indicate that Blacks and Hispanics have lower cognition scores at age 65, and individuals with a history of psychiatric problems show lower cognitive scores and steeper rates of decline as they age. These effects are partially mediated by early life disadvantage and later-life demographic, socioeconomic, or health characteristics. Overall, being Black results in a larger negative fixed effect on cognitive function for both men and women.

Implications: These findings demonstrate that cumulative disadvantage and a history of psychiatric or emotional problems interact to shape later life cognition and cognitive decline. This evidence can enhance public understanding of the trajectories of cognitive decline experienced by groups living with disadvantage. Improved awareness of this relationship, and of the manner in which specific groups are differentially affected by it, can enable policy-makers and human services providers to better design and implement preventative interventions and support services for affected populations.

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