Wei Zhang1, Fengyan Tang2, Yiwei Chen3, Merril Silverstein4, Sizhe Liu1, XinQi Dong5. 1. Department of Sociology, University of Hawai'i at Mānoa, Honolulu, Hawaii. 2. School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Psychology Department, Bowling Green State University, Bowling Green, Ohio. 4. Department of Sociology, Aging Studies Institute, Syracuse University, Syracuse, New York. 5. Health Care Policy and Aging Research, Institute for Health, The State University of New Jersey, Rutgers University, New Brunswick, NJ.
Abstract
OBJECTIVES: To examine whether and how early-life experiences such as years of schooling affect late-life cognitive function through a pathway of activity engagement. DESIGN: Prospective. SETTING: We used data from 2 waves of the Population Study of Chinese Elderly in Chicago (PINE). PARTICIPANTS: PINE is the largest population-based epidemiological study of Chinese-American adults aged 60 and older in the greater Chicago area. Wave 1 data were collected for 2 years, from July 2011 to June 2013, and Wave 2 data were collected from 2013 to 2015; total sample size was 2,713. MEASUREMENTS: Education was measured in years of schooling. Activity engagement was assessed using 15 items grouped into two clusters: cognitive activity and social activity. Cognitive function was evaluated using five instruments to assess general mental status (Chinese Mini-Mental State Examination (C-MMSE)), episodic memory, perceptual speed, working memory, global cognition score. RESULTS: Adjusting for sociodemographic and health-related control variables, education measured at Wave 1 was associated with better global cognition (b = 0.025, p < .001), C-MMSE (b = .037, p < .001), episodic memory (b = .026, p < .001), Symbol Digit Modalities Test perceptual speed (b = .036, p < .001), and Digit Span Backward working memory (b = .047, p < .001) at Wave 2. Activity engagement, cognitive activity in particular, significantly mediates the effect of education on all cognitive tests, with the size of the mediating effect ranging from 16% to approximately 24%. CONCLUSION: Amount of schooling early in life is significantly related to late-life cognitive function in virtually all domains, and cognitive activity is one of many links between the two. J Am Geriatr Soc 67:S525-S531, 2019.
OBJECTIVES: To examine whether and how early-life experiences such as years of schooling affect late-life cognitive function through a pathway of activity engagement. DESIGN: Prospective. SETTING: We used data from 2 waves of the Population Study of Chinese Elderly in Chicago (PINE). PARTICIPANTS: PINE is the largest population-based epidemiological study of Chinese-American adults aged 60 and older in the greater Chicago area. Wave 1 data were collected for 2 years, from July 2011 to June 2013, and Wave 2 data were collected from 2013 to 2015; total sample size was 2,713. MEASUREMENTS: Education was measured in years of schooling. Activity engagement was assessed using 15 items grouped into two clusters: cognitive activity and social activity. Cognitive function was evaluated using five instruments to assess general mental status (Chinese Mini-Mental State Examination (C-MMSE)), episodic memory, perceptual speed, working memory, global cognition score. RESULTS: Adjusting for sociodemographic and health-related control variables, education measured at Wave 1 was associated with better global cognition (b = 0.025, p < .001), C-MMSE (b = .037, p < .001), episodic memory (b = .026, p < .001), Symbol Digit Modalities Test perceptual speed (b = .036, p < .001), and Digit Span Backward working memory (b = .047, p < .001) at Wave 2. Activity engagement, cognitive activity in particular, significantly mediates the effect of education on all cognitive tests, with the size of the mediating effect ranging from 16% to approximately 24%. CONCLUSION: Amount of schooling early in life is significantly related to late-life cognitive function in virtually all domains, and cognitive activity is one of many links between the two. J Am Geriatr Soc 67:S525-S531, 2019.