RACE/ETHNICITY, EDUCATION &LATE LIFE COGNITIVE FUNCTION

Hebrew Rehabilitation Center For Aged, Boston MA

Investigators

Linked publications & trials

Abstract

Advanced age, level of educational attainment and race/ethnicity are consistently associated with poor cognition in studies concerning dementing disorders or cognitive impairments. Important evidence in the published literature questions the construct validity of cognitive status assessment across race/ethnicity and educational attainment groups. There is a very plausible explanation for observed differences in the relationship of cognitive status and other health outcomes across race/ethnicity and educational attainment groups: systematic measurement error (item bias) in the assessment of cognitive functioning across these groups. The aim of this proposal is to investigate this hypothesis by conducting an item response theory (IRT) based item bias evaluation of cognitive assessments of very old persons. Data will be obtained from a probability sample of very old continental U.S. residents. Specifically, (l) cognitive assessment data from the Asset and Health Dynamics of the Oldest Old (AHEAD) data set will be used to fit an IRT model to modified Telephone Interview for Cognitive Status responses from a sample of very old U.S. residents, and (2) item bias analyses will be conducted testing null hypotheses that, while holding constant group differences in underlying cognitive ability, the items are (a) free from bias according to race/ethnicity, and (b) free from bias according to level of educational attainment. Further (3) evidence of group differences in overall cognitive ability and systematic measurement error due to level of race/ethnicity educational attainment will be evaluated conditional on the rich array of sociodemographic and socioeconomic indicators present in the AHEAD data set. The proposed analysis represents a significant advance in the understanding of late life cognitive functioning by exploring how educational attainment, age, socioeconomic status and race/ethnicity affect cognitive assessment at the item level. Results from this work will (l) inform continuing efforts to develop culture fair cognitive assessment instruments, (2) promote understanding of race/ethnicity and education effects in cognitive assessment, and (3) will help explain race/ethnicity differences in the relation of cognition to other health status measures and suspected risk factors for cognitive decline and dementia.