The Importance of Improving Educational Attainment for Dementia Prevalence Trends From 2000 to 2014, Among Older Non-Hispanic Black and White Americans[Contribution of education, occupation and cognitively stimulating activities to the formation of cognitive reserve]

ObjectivesWhile a number of studies have documented a notable decline in age-standardized prevalence in dementia in the U.S. population, relatively little is known about how dementia has declined for specific age and race groups, and the importance of changing educational attainment on the downward trend. We assess (a) how the trends in dementia prevalence may have differed across age and race groups and (b) the role of changing educational attainment in understanding these trends.MethodsThis article estimates a series of logistic regression models using data from the Health and Retirement Study (2000–2014) to assess the relative annual decline in dementia prevalence and the importance of improving educational attainment for non-Hispanic Whites and non-Hispanic Blacks.ResultsConsistent with other studies, we found significant declines in dementia for non-Hispanic Blacks and non-Hispanic Whites across this period. Nonetheless, these declines were not uniform across age and race groups. Non-Hispanic Blacks aged 65–74 years had the steepest decline in this period. We also found that improved educational attainment in the population was fundamentally important in understanding declining dementia prevalence in the United States.DiscussionThis study shows the importance of improvement in educational attainment in the early part of the twentieth century to understand the downward trend in dementia prevalence in the United States from 2000 to 2014.