Racial/Ethnic and Nativity Differences in Cognitive Life Expectancies Among Older Adults in the United States
BACKGROUND AND OBJECTIVES To document racial/ethnic and nativity differences by gender in cognitive life expectancies among older adults in the United States. RESEARCH DESIGN AND METHODS Sullivan based life tables were used to estimate cognitively normal, cognitively impaired/no dementia (CIND) and dementia life expectancies by gender for White, Black, U.S. born Hispanic, and foreign born Hispanic adults 50 years and older in the Health and Retirement Study. RESULTS Among women, the number of years spent living with dementia for Whites, Blacks, U.S. born Hispanics, and foreign born Hispanics was 1.6, 3.9, 4.7, and 6.0 years, respectively. For men, Whites lived 1.1 years with dementia compared to 3.1 years for Blacks, 3.0 years for U.S. born Hispanics and 3.2 years for foreign born Hispanics. Similar patterns were observed for race/ethnic and nativity differences in CIND life expectancies. Blacks and Hispanics spend a larger fraction of their remaining years with CIND and dementia relative to Whites, regardless of gender. Foreign born Hispanic men and women and Black men are particularly disadvantaged in the proportion of years spent after age 50 with CIND and/or dementia. DISCUSSION AND IMPLICATIONS Disparities in cognitive life expectancies indicate that intervention strategies should target the specific needs of minority and immigrant older adults with dementia. Given that education is a strong predictor of cognitive health, improving access to the social and economic resources that delay dementia onset is key to improving the well being of diverse older adults.
The Gerontologist