We propose to examine the relationship between education and cognitive decline and mortality in old age using longitudinal data from the Health and Retirement Survey (HRS). Although the correlation between education and cognitive decline is well-documented, it is not known if this relationship is causal or due to confounding by individual characteristics such as cognitive ability or family economic status. Furthermore, if we assume this relationship is causal, the key mediators are unknown. We emphasize the importance of innovative analytic approaches in estimating the overall causal effect and in testing specific pathways. Our primary aims are: 1) to derive consistent estimates of the causal effect of education on cognitive change and mortality using instrumental variables analysis; 2) to test whether the effect of education on cognitive outcomes operates through a latency, social trajectory, or cumulative harm model; and 3) to provide unbiased estimates of the importance of three hypothesized pathways linking education and cognitive decline, using new analytic approaches emphasizing the time-varying nature of both mediators and confounders. These hypothesized pathways are: social ties, health behaviors, and cardiovascular health. Rapid changes in state educational policies influenced the educational attainment of birth cohorts in the first half of the 20 th century. Using such natural experiments, instrumental variables analyses can provide estimates of health effects of education, even when important confounders are unmeasured. State policy data on instruments such as compulsory schooling and term length, will be linked to individual level data from the Health and Retirement Survey (HRS). As of the 2002 interview wave, the combined HRS sample included 1 to 5 waves of memory and mental status assessments on over 25,000 participants.We will use innovative methods to test specific pathways while accounting for time-varying covariates. HRS contains detailed information on lifecourse socioeconomic position, including 40 years of Social Security earnings information on over 9,000 original sample members, and physical and behavioral characteristics assessed at up to 6 interview waves. We distinguish between alternative models of how adult socioeconomic trajectories may mediate the effect of education on cognitive decline. Finally, we use gestimation to examine the importance of social ties, health behaviors, and cardiovascular risk in mediating the effect of education on cognitive outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
1R01AG023399-01
Application #
6737302
Study Section
Special Emphasis Panel (ZRG1-SNEM-2 (50))
Program Officer
Elias, Jeffrey W
Project Start
2003-09-30
Project End
2006-08-31
Budget Start
2003-09-30
Budget End
2004-08-31
Support Year
1
Fiscal Year
2003
Total Cost
$244,750
Indirect Cost
Name
Harvard University
Department
Social Sciences
Type
Schools of Public Health
DUNS #
149617367
City
Boston
State
MA
Country
United States
Zip Code
02115
Haas, Steven A; Glymour, M Maria; Berkman, Lisa F (2011) Childhood health and labor market inequality over the life course. J Health Soc Behav 52:298-313
Patton, Kristen K; Benjamin, Emelia J; Kosheleva, Anna et al. (2011) Early-life antecedents of atrial fibrillation: place of birth and atrial fibrillation-related mortality. Ann Epidemiol 21:732-8
Rehkopf, David H; Jencks, Christopher; Glymour, M Maria (2010) The association of earnings with health in middle age: Do self-reported earnings for the previous year tell the whole story? Soc Sci Med 71:431-439
Glymour, M Maria; Kosheleva, Anna; Boden-Albala, Bernadette (2009) Birth and adult residence in the Stroke Belt independently predict stroke mortality. Neurology 73:1858-65
Maselko, Joanna; Bates, Lisa M; Avendano, Mauricio et al. (2009) The intersection of sex, marital status, and cardiovascular risk factors in shaping stroke incidence: results from the health and retirement study. J Am Geriatr Soc 57:2293-9
DeFries, Triveni; Avendano, Mauricio; Glymour, M Maria (2009) Level and change in cognitive test scores predict risk of first stroke. J Am Geriatr Soc 57:499-505
Glymour, M Maria; Avendano, Mauricio (2009) Can self-reported strokes be used to study stroke incidence and risk factors?: evidence from the health and retirement study. Stroke 40:873-9
Glymour, M Maria; Weuve, Jennifer; Fay, Martha E et al. (2008) Social ties and cognitive recovery after stroke: does social integration promote cognitive resilience? Neuroepidemiology 31:10-20
Glymour, M Maria; Defries, Triveni B; Kawachi, Ichiro et al. (2008) Spousal smoking and incidence of first stroke: the Health and Retirement Study. Am J Prev Med 35:245-8
Avendano, Mauricio; Glymour, M Maria (2008) Stroke disparities in older Americans: is wealth a more powerful indicator of risk than income and education? Stroke 39:1533-40

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