Postsecondary Education and Late-life Cognitive Outcomes Among Black and White Participants in the Project Talent Aging Study Can Early-life Cognitive Skills Account for Educational Differences in Late-life Cognition?

Background: Higher education consistently predicts improved late-life cognition. Racial differences in educational attainment likely contribute to inequities in dementia risk. However, few studies of education and cognition have controlled for prospectively measured early-life confounders or evaluated whether the education late-life cognition association is modified by race/ethnicity. Methods: Among 2343 Black and White Project Talent Aging Study participants who completed telephone cognitive assessments, we evaluated whether the association between years of education and cognition (verbal fluency, memory/recall, attention, and a composite cognitive measure) differed by race, and whether these differences persisted when adjusting for childhood factors, including the cognitive ability. Results: In fully adjusted linear regression models, each additional year of education was associated with higher composite cognitive scores for Black [beta=0.137; 95% confidence interval (CI)=0.068, 0.206] and White respondents (beta=0.056; CI=0.034, 0.078) with an interaction with race (P=0.03). Associations between education and memory/recall among Black adults (beta=0.036; CI=-0.037, 0.109) and attention among White adults (beta=0.022; CI=-0.002, 0.046) were nonsignificant. However, there were significant race-education interactions for the composite (P=0.03) and attention measures (P<0.001) but not verbal fluency (P=0.61) or memory/recall (P=0.95). Conclusion: Education predicted better overall cognition for both Black and White adults, even with stringent control for prospectively measured early-life confounders.