1. Education Mediates Racial Disparities in Cognitive Impairment Among Older Adults With Schizophrenia
- Author
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Sarah Dobbins, Erin Hubbard, and Heather Leutwyler
- Subjects
Cognitive aging ,Mediation (statistics) ,Health (social science) ,Social Psychology ,education ,Population ,Article ,03 medical and health sciences ,Race (biology) ,fluids and secretions ,0302 clinical medicine ,Cognition ,parasitic diseases ,medicine ,Humans ,Cognitive Dysfunction ,Social determinants of health ,Cognitive impairment ,Aged ,education.field_of_study ,030214 geriatrics ,Racial Groups ,medicine.disease ,body regions ,Clinical Psychology ,Schizophrenia ,Educational Status ,Geriatrics and Gerontology ,Construct (philosophy) ,Psychology ,Gerontology ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
In the general population, the construct of race is associated with disparities in cognitive aging. There are notable racial group disparities and inequities among people living with schizophrenia (PLWSz). Despite the salience of the construct of race in schizophrenia, there remains a knowledge gap about racial disparities in cognitive impairment among older adults in this vulnerable population. Our study uses mediation analysis to examine racial disparities in cognitive impairment among older adults with schizophrenia.We assess global cognition in PLWSz over age 55 with the Measurement and Treatment Research to Improve Cognition in Schizophrenia cognitive test battery in our "all-comer" sample (There was a Black/non-Black group racial disparity in global cognitive score (-2.8, 95% CI: -4.4, -1.3) after adjusting for confounding and interaction. This disparity was significantly mediated by years of education.There are notable racial disparities in cognitive impairment among older adults with schizophrenia; however, differences in cognitive scores between racial groups are mediated by level of education.Social determinants of health, particularly educational attainment, are important risk factors for cognitive impairment in PLWSz and should be considered by clinicians. Early screening and assessment of cognitive symptoms is essential to addressing health disparities/inequalities among older adults living with schizophrenia.Controlled Direct EffectsHIV: Human Immunodeficiency VirusMATRICS: Measurement and Treatment Research to Improve Cognition in SchizophreniaMCCB: MATRICS Consensus Cognitive BatteryMTE: Marginal Total EffectsNDE: Natural Direct EffectsPANSS: Positive and Negative Symptom ScalePLWSz: People with schizophrenia.
- Published
- 2024