An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States

J Aging Health. 2024 Mar;36(3-4):230-245. doi: 10.1177/08982643231184593. Epub 2023 Jun 19.

Abstract

Objectives: Cognitive aging is a lifelong process with implications for Alzheimer's disease and dementia. This study aims to fill major gaps in research on the natural history of and social disparities in aging-related cognitive decline over the life span. Methods: We conducted integrative data analysis of four large U.S. population-based longitudinal studies of individuals aged 12 to 105 followed over two decades and modeled age trajectories of cognitive function in multiple domains. Results: We found evidence for the onset of cognitive decline in the 4th decade of life, varying gender differences with age, and persistent disadvantage among non-Hispanic Blacks, Hispanics, and those without college education. We further found improvement in cognitive function across 20th century birth cohorts but widening social inequalities in more recent cohorts. Discussion: These findings advance an understanding of early life origins of dementia risk and invite future research on strategies for promoting cognitive health for all Americans.

Keywords: and educational disparities; cognitive aging; cognitive decline; dementia risk; gender; life course trajectories; race/ethnicity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / psychology
  • Child
  • Cognitive Aging*
  • Cognitive Dysfunction* / epidemiology
  • Dementia* / epidemiology
  • Health Status Disparities*
  • Humans
  • Life Change Events
  • Middle Aged
  • United States / epidemiology
  • Young Adult