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doi

PMCID

NIHMSID

Life

Course

Pathways

to

Racial

Disparities

in

Cognitive

Impairment

among

Older

Americans

Zhenmei

Zhang

Mark

D

Hayward

and

YanLiang

Yu

Author

information

Copyright

and

License

information

Go

to

Abstract

Blacks

are

especially

hard

hit

by

cognitive

impairment

at

older

ages

compared

to

whites

Here

we

take

advantage

of

the

Health

and

Retirement

Study

to

assess

how

this

racial

divide

in

cognitive

impairment

is

associated

with

the

racial

stratification

of

life

course

exposures

and

resources

over

a

period

among

nonHispanic

whites

and

blacks

aged

and

older

in

We

find

that

blacks

suffer

from

a

higher

risk

of

moderatesevere

cognitive

impairment

at

baseline

and

during

the

followup

Blacks

are

also

more

likely

to

report

childhood

adversity

and

to

have

grown

up

in

the

segregated

South

and

In

approximately

of

Americans

aged

and

older

had

dementia

and

had

cognitive

impairment

without

dementia

Plassman

et

al

Plassman

et

al

with

the

prevalence

rates

rising

sharply

with

age

For

example

about

of

those

aged

were

estimated

to

have

dementia

compared

to

of

those

aged

and

of

those

aged

and

older

Plassman

et

al

The

national

economic

cost

of

informal

home

care

for

older

adults

with

mild

moderate

and

severe

cognitive

impairment

was

estimated

to

be

more

than

billion

in

Langa

et

al

More

recent

estimates

of

dementia

care

direct

costs

and

informal

care

for

were

as

high

as

billion

in

the

United

States

Wimo

Winblad

and

Jönsson

Blacks

are

especially

hard

hit

by

cognitive

impairment

and

dementia

Estimates

of

dementia

prevalence

rates

in

the

older

population

are

substantially

higher

for

blacks

than

for

whites

Manly

and

Mayeux

Shadlen

et

al

Taylor

Sloan

and

Doraiswamy

prompting

the

Alzheimers

Association

to

identify

Alzheimers

disease

as

an

emerging

public

health

crisis

among

older

blacks

Alzheimers

Association

According

to

the

latest

estimates

from

the

prevalence

of

cognitive

impairment

among

Americans

aged

and

older

was

percent

for

whites

and

percent

for

blacks

Alzheimers

Association

Blacks

also

have

a

higher

prevalence

of

vascular

dementia

than

whites

Froehlich

Bogardus

and

Inouye

However

despite

the

racial

gap

in

prevalence

there

are

surprisingly

few

populationlevel

longitudinal

studies

that

have

investigated

the

origins

and

mechanisms

through

which

the

racial

gap

in

cognitive

impairment

is

produced

Here

drawing

on

seven

waves

of

the

Health

and

Retirement

Study

HRS

we

investigate

how

racial

differences

in

the

onset

of

moderatesevere

cognitive

impairment

among

older

Americans

are

tied

to

the

racial

stratification

of

socioeconomic

conditions

and

health

over

the

life

course

Our

life

course

approach

of

incorporating

both

childhood

and

adulthood

conditions

allows

us

to

assess

potential

pathways

through

which

racial

disparities

are

produced

Go

to

BACKGROUND

Childhood

Conditions

Adult

Socioeconomic

StatusSES

and

Cognitive

Impairment

in

Later

life

The

life

course

perspective

has

often

been

invoked

to

understand

the

origins

of

SES

and

racial

disparities

in

adult

health

and

mortality

ORand

and

HamilLuker

Pavalko

and

Caputo

Warner

and

Hayward

In

recent

years

researchers

have

also

turned

to

this

perspective

to

examine

the

determinants

of

cognitive

function

in

later

life

as

well

as

racial

and

ethnic

differences

in

cognitive

aging

Glymour

and

Manly

Luo

and

Waite

The

usefulness

of

the

life

course

approach

is

rooted

in

the

age

patterning

of

cognitive

function

over

the

life

course

wherein

cognitive

function

shows

rapid

growth

and

development

in

the

early

years

rising

to

a

peak

or

plateau

at

maturity

and

then

a

gradual

decline

with

age

Kuh

The

brain

reserve

obtained

at

maturity

and

the

rate

of

decline

ultimately

determine

when

the

threshold

for

cognitive

impairment

is

crossed

A

growing

body

of

literature

provides

empirical

evidence

that

cognitive

impairment

in

later

life

is

rooted

at

least

in

part

in

childhood

Deary

et

al

Scazufca

et

al

Zhang

Gu

and

Hayward

Although

the

exact

biological

behavioral

and

psychosocial

mechanisms

linking

childhood

conditions

and

latelife

cognitive

impairment

remain

unclear

two

general

mechanisms

have

been

offered

to

explain

the

association

One

mechanism

posits

that

earlylife

adversity

may

have

direct

effects

on

latelife

cognition

because

of

impairments

in

brain

development

The

brain

grows

and

develops

most

during

the

prenatal

period

and

the

first

few

years

of

life

and

continues

to

grow

in

childhood

and

adolescence

Lupien

et

al

Thus

insults

such

as

poverty

hunger

poor

nutrition

chronic

stress

and

poor

health

that

occur

during

early

childhood

and

adolescence

are

particularly

harmful

because

they

may

impair

the

development

of

many

regions

of

the

brain

and

have

longterm

ramifications

including

less

myelin

less

branching

of

dendrites

and

less

developed

connectivity

patterns

in

the

brain

Moceri

et

al

In

other

words

earlylife

factors

may

strongly

influence

the

brain

reserve

or

biological

capacity

acquired

at

maturity

Compelling

evidence

from

research

on

childhood

SES

and

brain

development

using

behavioral

electrophysiological

and

neuroimaging

methods

shows

that

in

early

childhood

there

are

already

SES

disparities

in

neurocognitive

function

Hackman

and

Farah

Recent

birth

cohort

studies

in

Britain

found

that

childhood

cognitive

ability

was

negatively

associated

with

cognitive

decline

in

midlife

as

well

as

the

risk

of

lateonset

dementia

suggesting

that

cognitive

deficits

in

early

life

may

put

individuals

at

higher

risk

of

cognitive

impairment

in

later

life

Richards

et

al

Whalley

et

al

Consistent

with

this

idea

research

in

both

developed

and

developing

countries

has

reported

that

earlylife

nutritional

deprivation

eg

measured

by

hunger

and

shorter

stature

and

other

childhood

socioeconomic

disadvantages

are

associated

with

cognitive

impairment

and

dementia

in

later

life

net

of

adulthood

socioeconomic

achievement

Huang

et

al

Melrose

et

al

Zhang

Gu

and

Hayward

An

alternative

yet

complementary

perspective

posits

that

earlylife

circumstances

may

indirectly

influence

cognitive

impairment

via

educational

attainment

occupation

income

health

behaviors

and

chronic

diseases

Education

can

promote

brain

growth

and

enable

the

brain

network

to

operate

more

efficiently

Thus

individuals

with

a

higher

level

of

education

may

enter

old

age

with

a

greater

number

of

synapses

which

would

provide

protection

against

cognitive

decline

in

later

life

and

delay

the

onset

of

cognitive

impairment

Alley

Suthers

and

Crimmins

Fritsch

et

al

Higher

levels

of

education

often

lead

to

occupations

that

involve

cognitive

challenges

and

practice

which

could

further

enhance

cognitive

function

in

adulthood

Schooler

Education

also

shapes

health

behaviors

throughout

the

life

course

For

example

the

well

educated

are

more

likely

to

exercise

to

drink

moderately

and

to

avoid

smoking

all

of

which

are

associated

with

good

cognitive

health

in

later

life

Cutler

and

LlerasMuney

Lee

et

al

Peters

et

al

Not

surprisingly

many

studies

have

shown

that

a

greater

number

of

years

of

education

and

good

quality

of

schooling

eg

literacy

and

reading

ability

are

associated

with

better

cognitive

function

slower

cognitive

decline

and

a

lower

risk

of

dementia

in

later

life

Alley

et

al

Jefferson

et

al

Reuser

Willekens

and

Bonneux

Shadlen

et

al

Higher

income

and

wealth

can

reduce

older

adults

exposure

to

stress

associated

with

financial

strains

Kahn

and

Pearlin

Lynch

Kaplan

and

Shema

and

perceived

stress

has

been

associated

with

faster

cognitive

decline

and

a

higher

risk

of

dementia

Aggarwal

et

al

Chiao

Botticello

and

Fuh

Johansson

et

al

A

few

studies

have

found

that

selfreported

household

income

and

financial

inadequacy

predicted

cognitive

function

cognitive

decline

and

dementia

among

older

adults

Chiao

et

al

Luo

and

Waite

Yaffe

et

al

see

Gonzalez

et

al

for

an

exception

In

addition

poor

earlylife

conditions

can

increase

the

risk

of

hypertension

heart

disease

and

stroke

in

adulthood

which

in

turn

adversely

affects

latelife

cognitive

function

ORand

and

HamilLuker

Turrell

et

al

It

is

important

to

point

out

that

the

determinants

of

cognitive

health

in

later

life

are

multifactorial

Earlylife

environment

genetic

predisposition

adulthood

socioeconomic

resources

diet

illness

and

social

engagement

are

associated

with

cognitive

function

in

later

life

Deary

et

al

The

two

conceptual

models

for

the

effects

of

childhood

conditions

on

latelife

cognition

are

not

mutually

exclusive

and

may

operate

together

in

complex

ways

It

is

possible

that

some

childhood

conditions

may

affect

cognition

directly

while

others

may

act

indirectly

via

factors

in

adulthood

Karp

et

al

Zhang

et

al

Racial

Differences

in

Childhood

Conditions

and

Adulthood

SES

and

Health

Throughout

US

history

race

has

been

one

of

the

most

important

social

stratification

systems

that

puts

blacks

at

a

substantial

socioeconomic

disadvantage

throughout

the

life

course

Hayward

et

al

Zsembik

and

Peek

Older

blacks

are

more

likely

to

report

that

they

experienced

poverty

and

poor

health

in

their

childhood

than

older

whites

in

national

surveys

Warner

and

Hayward

While

growing

up

in

the

early

and

in

the

South

blacks

lived

in

vastly

different

social

and

physical

environments

from

whites

as

a

result

of

discrimination

residential

segregation

and

restricted

access

to

education

Barnes

et

al

Recent

research

has

suggested

that

having

lived

in

the

South

while

growing

up

may

be

particular

harmful

for

older

blacks

cognition

in

part

because

of

the

very

different

schooling

experiences

for

blacks

and

whites

until

the

Supreme

Courts

Brown

vs

Board

of

Education

decision

of

which

declared

state

laws

upholding

school

segregation

unconstitutional

Before

the

legally

imposed

desegregation

blacks

not

only

attended

schools

with

much

poorer

funding

and

lower

quality

than

those

attended

by

whites

in

the

South

but

also

spent

fewer

days

at

schools

School

terms

for

white

children

were

longer

than

those

for

black

children

in

Glymour

and

Manly

These

disadvantages

of

schooling

for

black

children

in

the

South

might

have

negatively

affected

their

cognitive

development

Lee

Ceci

As

a

consequence

of

poverty

discrimination

and

restricted

access

to

medical

care

there

is

a

large

racial

gap

in

childhood

health

throughout

the

th

century

Costa

For

example

low

birth

weight

rate

and

infant

mortality

rate

among

blacks

were

approximately

twice

as

high

as

they

were

among

whites

in

the

first

third

of

the

th

century

Costa

Guyer

et

al

Entering

early

adulthood

blacks

are

more

likely

than

whites

to

complete

fewer

years

of

schooling

to

have

marginal

jobs

to

earn

lower

income

and

to

have

higher

unemployment

rates

due

to

residential

segregation

and

occupational

discrimination

Hayward

et

al

Williams

and

Sternthal

In

particular

there

is

an

enormous

gap

in

wealth

accumulation

between

blacks

and

whites

Shapiro

Meschede

and

Sullivan

According

to

estimates

in

the

mean

household

wealth

for

whites

is

more

than

three

times

that

of

blacks

In

addition

at

every

education

and

income

quartile

level

blacks

accumulate

far

less

wealth

than

their

white

counterparts

due

in

part

to

their

lower

income

poorer

health

and

smaller

inheritance

as

well

as

the

limited

appreciation

of

home

equity

in

segregated

neighborhoods

Choudhury

Colen

Wealth

is

an

important

component

of

economic

wellbeing

because

it

offers

people

some

protection

against

life

events

that

cause

financial

stress

such

as

periods

of

unemployment

business

losses

marital

losses

and

bouts

of

major

illness

Recent

research

shows

that

both

income

and

wealth

are

significant

predictors

of

morbidity

and

mortality

Huie

et

al

Hummer

and

Chinn

Pollack

et

al

In

addition

to

wide

racial

gaps

in

SES

research

shows

that

there

are

also

significant

racial

differences

in

health

behaviors

such

as

smoking

drinking

and

sedentary

behavior

Dubowitz

et

al

Kurian

and

Cardarelli

and

that

blacks

have

earlier

onset

and

higher

prevalence

of

major

chronic

diseases

such

as

hypertension

heart

disease

stroke

and

diabetes

than

whites

Geronimus

Hayward

et

al

Taken

together

the

current

literature

shows

that

compared

to

whites

blacks

are

exposed

to

substantial

socioeconomic

disadvantages

in

childhood

and

throughout

their

adulthood

Warner

and

Hayward

Williams

and

Sternthal

It

is

important

to

understand

how

early

disadvantages

for

blacks

in

comparison

to

whites

shape

significant

racial

differences

in

cognitive

impairment

in

later

life

Specifically

we

are

interested

in

finding

out

how

racial

differences

in

childhood

conditions

adulthood

SES

adult

health

and

heath

behaviors

influence

the

racial

gap

in

cognitive

impairment

Guided

by

the

life

course

perspective

and

drawing

on

prior

research

on

the

racial

gap

in

cognitive

impairment

we

examine

the

following

hypotheses

Compared

to

whites

blacks

are

more

likely

to

suffer

from

a

higher

risk

of

cognitive

impairment

at

baseline

and

during

the

followup

Blacks

higher

risk

of

cognitive

impairment

at

baseline

and

during

followup

will

be

significantly

reduced

when

childhood

health

and

adversity

are

controlled

for

Blacks

higher

risk

of

cognitive

impairment

will

be

further

reduced

when

adulthood

socioeconomic

achievement

chronic

disease

and

health

behaviors

are

controlled

for

in

addition

to

childhood

conditions

Go

to

DATA

AND

METHODS

We

used

data

from

waves

of

the

HRS

to

investigate

life

course

origins

and

pathways

of

the

racial

gap

in

cognitive

impairment

in

later

life

The

wave

of

the

HRS

used

a

nationally

representative

sample

of

noninstitutionalized

adults

older

than

and

included

information

from

respondents

It

also

oversampled

blacks

and

Hispanics

The

HRS

first

asked

all

respondents

about

childhood

conditions

in

The

survey

collected

detailed

information

on

cognitive

physical

economic

work

and

family

conditions

as

well

as

health

behaviors

approximately

every

two

years

either

by

telephone

or

in

person

About

of

the

interviews

Langa

et

al

We

have

retained

respondents

with

proxy

reports

in

our

analysis

Our

analytic

sample

included

nonHispanic

blacks

hereafter

blacks

and

nonHispanic

whites

hereafter

whites

aged

and

over

who

lived

in

the

community

in

Many

respondents

had

missing

data

for

mothers

or

fathers

education

In

order

to

retain

these

cases

we

imputed

the

values

and

details

were

described

below

We

excluded

respondents

who

had

missing

values

on

childhood

health

adult

health

or

health

behaviors

which

resulted

in

respondents

Among

the

respondents

at

baseline

respondents

were

considered

cognitively

unimpaired

and

we

followed

them

Measures

The

measurement

of

cognitive

status

in

the

HRS

our

dependent

variable

differed

for

self

and

proxy

respondents

Cognitive

tests

were

administered

in

all

waves

of

the

HRS

to

selfrespondents

and

can

be

used

to

track

the

cognitive

transitions

of

respondents

over

time

We

used

the

summary

measure

of

cognitive

function

which

was

based

on

the

modified

version

of

the

Telephone

Interview

for

Cognitive

Status

TICS

to

classify

respondents

cognitive

status

The

modified

version

of

TICS

included

date

identification

object

naming

naming

of

the

President

and

Vice

President

serial

subtraction

of

and

tests

of

immediate

and

delayed

recall

of

Ofstedal

Fisher

and

Herzog

We

used

the

imputed

cognitive

variables

released

by

the

HRS

in

our

analysis

Following

previous

research

Freedman

Aykan

and

Martin

Herzog

and

Wallace

Reuser

et

al

we

classified

respondents

as

having

moderatesevere

cognitive

impairment

if

they

scored

an

or

lower

out

of

at

baseline

In

additional

analysis

we

examined

cutoff

points

of

and

and

the

results

not

shown

were

similar

For

followup

surveys

we

increased

the

cutoff

point

by

and

classified

those

who

scored

or

less

as

moderatelyseverely

impaired

Previous

research

suggested

that

a

higher

cutoff

point

for

cognitive

impairment

was

appropriate

for

HRS

followup

surveys

to

account

for

practice

effects

Lièvre

Alley

and

Crimmins

Reuser

et

al

For

sample

members

who

were

unable

to

participate

in

the

cognitive

tests

proxies

were

asked

to

report

on

a

list

of

symptoms

of

cognitive

impairment

Five

symptoms

were

consistently

asked

about

from

to

got

lost

in

a

familiar

environment

wandered

off

and

did

not

return

by

himselfherself

could

not

be

left

alone

for

an

hour

had

hallucinations

and

had

poor

memory

In

a

recent

paper

Crimmins

et

al

found

that

difficulty

with

eating

and

difficulty

with

managing

money

were

significantly

associated

with

clinical

diagnosis

of

dementia

in

the

Aging

Demographics

and

Memory

Study

ADAMS

We

thus

constructed

a

summary

score

ranging

from

no

symptoms

of

cognitive

impairment

to

severely

impaired

based

on

reports

of

the

abovementioned

five

symptoms

of

cognitive

impairment

and

of

difficulties

with

the

two

daily

activities

of

eating

and

managing

money

Respondents

who

had

two

or

more

of

these

symptoms

were

identified

as

moderatelyseverely

cognitively

impaired

In

sum

for

those

previously

identified

as

free

of

cognitive

impairment

we

defined

the

onset

of

cognitive

Independent

Variables

Our

key

independent

variables

included

selfreported

race

childhood

conditions

adulthood

SES

health

and

health

behaviors

Childhood

conditions

Childhood

condition

indicators

included

childhood

health

childhood

SES

and

birth

region

All

variables

were

created

based

on

respondents

answers

to

questions

on

their

health

and

family

circumstances

when

they

were

growing

up

from

birth

to

age

Childhood

health

was

based

on

the

respondents

rating

of

his

or

her

health

as

a

child

on

a

scale

ranging

from

poor

to

excellent

We

dichotomized

the

measure

into

poor

fair

and

poor

vs

good

goodvery

goodexcellent

Previous

research

has

shown

that

the

retrospective

measure

of

overall

childhood

health

was

valid

and

showed

good

reliability

over

time

Haas

Smith

Cumulative

childhood

adversity

was

assessed

with

an

index

that

included

four

items

fathers

education

than

years

mothers

education

than

years

fathers

occupation

collar

work

including

farmingfishingforestry

sales

operators

of

machines

mechanicsrepair

clerical

support

personal

services

and

dont

know

and

subjective

assessment

of

familys

financial

situation

family

was

poor

The

index

ranged

from

most

advantaged

to

most

disadvantaged

A

significant

proportion

of

respondents

had

missing

data

for

mothers

or

fathers

education

Following

the

practice

of

other

researchers

Luo

and

Waite

Montez

and

Hayward

we

imputed

the

missing

data

as

less

than

years

of

education

Our

preliminary

analysis

also

showed

that

respondents

who

had

missing

data

on

parental

education

were

similar

on

other

indicators

of

family

economic

circumstances

in

childhood

to

those

adults

whose

parents

had

less

than

years

of

education

Finally

we

used

a

Southern

birth

variable

to

classify

those

respondents

whose

selfreported

states

of

birth

were

defined

as

part

of

the

Southern

region

by

the

US

Census

All

childhood

variables

came

from

HRS

We

created

three

blocks

of

variables

to

evaluate

the

direct

and

indirect

pathways

of

earlylife

environment

on

racial

gaps

in

latelife

cognitive

impairment

Adulthood

SES

Adulthood

SES

was

measured

using

education

household

income

and

net

household

wealth

Education

was

measured

in

four

categories

less

than

years

and

or

more

years

Household

income

a

timevarying

variable

measured

the

total

household

income

in

the

year

prior

to

each

interview

wave

Net

household

wealth

was

also

measured

as

a

timevarying

variable

representing

the

value

of

household

assets

minus

debts

Both

household

income

and

household

wealth

were

adjusted

by

adding

constants

to

eliminate

zero

income

and

negative

wealth

the

values

were

then

divided

by

the

square

root

of

household

size

and

logged

Glymour

et

al

Zhang

and

Hayward

The

household

income

and

wealth

data

were

provided

by

the

RAND

Center

for

the

Study

of

Aging

version

L

which

consistently

imputed

missing

income

and

wealth

data

across

waves

Adult

health

Chronic

disease

was

measured

with

a

timevarying

dichotomous

variable

It

compared

those

respondents

who

reported

having

heart

disease

hypertension

diabetes

or

stroke

with

those

who

had

of

these

diseases

These

conditions

were

included

because

of

prior

studies

pointing

to

racial

differences

in

these

chronic

diseases

Hayward

et

al

LaVeist

et

al

Mensah

et

al

which

put

older

adults

at

higher

risk

of

cognitive

impairment

SinghManoux

and

Marmot

Tilvis

et

al

Health

behaviors

We

examined

three

health

behaviors

exercise

smoking

and

drinking

Exercise

was

coded

as

a

dummy

variable

which

compared

respondents

that

participated

in

vigorous

physical

activity

or

exercise

three

times

a

week

or

more

over

the

past

months

reference

with

those

who

did

not

Because

the

question

on

exercise

changed

over

waves

we

only

included

exercise

at

baseline

in

the

analysis

We

coded

smoking

into

three

categories

never

smoked

reference

former

smoker

and

current

smoker

Drinking

was

coded

into

four

categories

never

drank

former

drinker

current

light

drinker

reference

and

current

heavy

drinker

Light

drinker

referred

to

those

who

on

Lin

Guerrieri

and

Moore

Control

Variables

We

controlled

for

demographic

variables

including

age

gender

and

marital

status

Age

was

a

continuous

variable

Marital

status

had

four

categories

marriedcohabiting

reference

divorcedseparated

widowed

and

never

married

We

also

created

a

dummy

variable

to

indicate

whether

a

proxy

respondent

was

used

for

an

individual

who

was

unable

to

participate

in

the

cognitive

tests

Analytic

Strategy

We

began

by

looking

at

racial

differences

in

the

prevalence

of

cognitive

impairment

at

baseline

and

examining

the

role

of

childhood

conditions

and

education

in

explaining

the

racial

disparity

Then

we

analyzed

racial

difference

in

the

incidence

of

cognitive

impairment

from

to

When

we

examined

the

incidence

of

cognitive

impairment

the

risk

set

was

persons

free

of

cognitive

impairment

The

three

possible

ways

out

of

the

risk

set

were

being

observed

at

followup

in

one

of

three

states

cognitively

impaired

dead

or

lost

to

followup

The

nonmortal

outcomes

were

assumed

to

be

absorbing

and

thus

we

did

not

Warner

and

Hayward

We

estimated

all

models

using

SAS

and

adjusted

for

the

complex

sampling

design

of

the

HRS

All

models

were

based

on

weighted

data

using

HRS

sampling

weights

Go

to

RESULTS

We

present

weighted

sample

means

by

race

at

baseline

in

Table

to

show

the

extent

of

differences

in

social

and

economic

resources

between

blacks

and

whites

in

childhood

and

adulthood

As

expected

blacks

on

average

report

growing

up

in

more

disadvantaged

socioeconomic

environments

than

whites

On

the

index

of

cumulative

childhood

adversity

blacks

average

score

is

compared

to

for

whites

About

of

blacks

were

born

in

the

South

compared

to

about

of

whites

Although

slightly

more

blacks

report

poor

health

in

childhood

than

whites

the

difference

is

not

statistically

significant

In

terms

of

adulthood

economic

achievement

the

blackwhite

gaps

appear

wider

Blacks

are

more

Table

Weighted

Descriptive

Statistics

by

Race

Health

and

Retirement

Study

As

is

shown

in

Table

the

prevalence

of

cognitive

impairment

for

blacks

is

more

than

three

times

that

for

whites

vs

at

baseline

and

a

higher

proportion

of

blacks

had

proxy

reports

than

whites

Table

presents

the

estimated

prevalence

of

cognitive

impairment

by

age

and

gender

for

blacks

and

whites

in

At

each

age

listed

black

men

and

black

women

have

much

higher

prevalence

of

impairment

than

their

white

counterparts

Moreover

the

prevalence

rates

for

blacks

at

each

age

are

not

reached

for

whites

until

roughly

ten

years

later

For

example

the

prevalence

of

cognitive

impairment

for

black

men

at

age

is

whereas

the

prevalence

for

white

men

at

age

is

Table

Prevalence

of

Cognitive

Impairment

by

Race

and

Gender

Groups

Health

and

Retirement

Study

What

factors

contribute

to

the

higher

prevalence

of

cognitive

impairment

among

blacks

at

baseline

We

examined

the

roles

of

childhood

conditions

and

education

in

Table

As

is

shown

in

Model

the

odds

of

impairment

for

blacks

are

times

the

odds

for

whites

controlling

for

demographic

variables

and

proxy

reports

Introducing

childhood

conditions

in

Model

reduces

the

odds

of

impairment

for

blacks

from

to

We

find

that

being

born

in

the

South

is

associated

with

higher

odds

of

cognitive

impairment

In

Model

we

add

education

In

accordance

with

the

results

of

previous

studies

a

lower

level

of

education

is

associated

with

higher

odds

of

impairment

Although

the

race

gap

is

further

reduced

the

odds

of

impairment

for

blacks

are

still

Table

Logistic

Regressions

of

the

Odds

of

Cognitive

Impairment

among

Older

Americans

Health

and

Retirement

Study

Next

we

turn

to

a

series

of

nested

multinomial

logistic

regression

models

to

examine

a

whether

there

are

racial

differences

in

the

onset

of

cognitive

impairment

from

to

among

those

whose

cognition

is

considered

unimpaired

at

baseline

and

b

the

extent

to

which

the

racial

gap

in

impairment

is

explained

by

childhood

and

adulthood

circumstances

Table

summarizes

the

results

from

our

six

models

First

it

is

evident

in

Model

that

the

odds

of

experiencing

the

onset

of

cognitive

impairment

for

blacks

are

approximately

times

the

odds

for

whites

net

of

control

variables

Note

that

in

Table

we

showed

that

blacks

are

already

significantly

more

likely

to

be

impaired

at

baseline

The

incidence

results

show

the

persistence

of

blacks

disadvantage

in

the

followup

Table

Multinomial

Logistic

Regressions

of

the

Odds

of

Cognitive

Impairment

Death

and

Loss

to

FollowUp

among

Cognitively

Unimpaired

Older

Americans

Health

and

Retirement

Study

When

childhood

conditions

are

added

in

Model

of

Table

the

odds

of

impairment

for

blacks

are

reduced

from

to

This

reduction

primarily

stems

from

racial

differences

in

cumulative

childhood

adversity

and

birth

region

which

are

significantly

associated

with

odds

of

cognitive

impairment

With

each

additional

point

on

the

cumulative

childhood

adversity

index

the

odds

of

impairment

increase

by

To

put

it

another

way

the

odds

of

impairment

for

those

who

are

most

disadvantaged

in

childhood

ie

those

with

a

score

of

on

the

cumulative

childhood

adversity

index

are

times

the

odds

for

the

most

advantaged

ie

those

with

a

score

of

Being

born

In

Model

the

odds

of

cognitive

impairment

for

blacks

are

further

reduced

when

education

is

introduced

into

the

model

Consistent

with

previous

research

we

find

that

low

levels

of

education

are

associated

with

a

higher

risk

of

impairment

Moreover

after

adding

education

the

effect

of

cumulative

childhood

adversity

on

impairment

is

reduced

and

no

longer

statistically

significant

accounting

for

education

also

slightly

attenuates

the

effect

of

Southern

birth

though

it

remains

statistically

significant

When

we

add

adulthood

income

and

wealth

in

Model

the

odds

of

cognitive

impairment

for

blacks

are

reduced

slightly

Those

with

higher

household

income

have

a

significantly

lower

risk

of

impairment

Overall

Models

suggest

that

adult

SES

in

the

form

of

educational

attainment

and

household

income

are

strongly

and

negatively

associated

with

the

incidence

of

impairment

net

of

childhood

conditions

Nonetheless

even

after

accounting

for

racial

gaps

in

childhood

conditions

and

adulthood

SES

blacks

are

still

more

likely

to

experience

the

onset

of

cognitive

impairment

than

whites

When

the

chronic

disease

measures

are

introduced

into

Model

the

racial

gap

barely

changes

from

an

odds

ratio

of

to

This

finding

suggests

that

once

childhood

conditions

and

adult

SES

are

controlled

for

chronic

disease

accounts

for

little

of

blacks

higher

risk

of

impairment

Since

adulthood

SES

and

chronic

disease

are

intertwined

we

estimated

another

model

results

not

shown

that

included

demographic

controls

proxy

reports

childhood

conditions

and

chronic

disease

Compared

to

the

results

in

Model

that

controlled

for

childhood

conditions

only

the

odds

of

impairment

for

blacks

changed

from

to

results

not

shown

The

final

model

Model

introduces

three

health

behavior

measures

Similar

to

what

happens

when

controlling

for

chronic

disease

status

the

racial

gap

in

cognitive

impairment

does

not

change

when

current

health

behaviors

are

controlled

for

In

additional

analyses

results

not

shown

we

add

each

health

behavior

separately

and

the

results

are

similar

to

those

in

Model

Note

that

the

effect

of

Southern

birth

on

impairment

is

slightly

reduced

in

Model

compared

to

Model

but

remains

statistically

significant

The

effects

of

education

and

household

income

on

the

risk

of

impairment

also

remain

strong

and

robust

in

Model

Table

show

that

once

childhood

conditions

and

adulthood

SES

and

health

are

controlled

for

health

behaviors

explain

very

little

of

the

remaining

racial

gaps

in

the

onset

of

cognitive

impairment

The

eighth

column

of

Table

shows

the

odds

of

death

relative

to

being

cognitively

unimpaired

from

to

Cognitively

unimpaired

blacks

are

significantly

less

likely

to

die

than

their

white

counterparts

controlling

for

other

variables

in

Model

While

childhood

conditions

have

no

independent

effects

on

mortality

adulthood

SES

indicators

such

as

household

income

and

wealth

exert

powerful

effects

on

the

odds

of

death

net

of

controls

As

expected

chronic

disease

health

behaviors

demographic

variables

and

proxy

reports

are

strongly

associated

with

mortality

The

last

column

of

Table

shows

the

odds

of

loss

to

followup

relative

to

being

cognitively

unimpaired

Only

a

few

variables

are

statistically

significant

Respondents

with

higher

scores

on

the

cumulative

childhood

adversity

index

are

more

likely

to

drop

out

of

the

study

than

those

who

are

less

disadvantaged

The

more

wealthy

respondents

are

more

likely

to

drop

out

Those

who

have

chronic

disease

and

proxy

reports

are

also

more

likely

to

drop

out

Go

to

DISCUSSION

As

stated

earlier

we

have

two

goals

in

this

study

One

is

to

examine

whether

there

is

a

racial

gap

in

the

risk

of

cognitive

impairment

in

later

life

the

second

is

to

investigate

childhood

conditions

and

adulthood

SES

health

and

health

behaviors

as

important

pathways

by

which

the

racial

gap

is

generated

We

hypothesized

that

the

higher

risk

for

blacks

of

cognitive

impairment

was

largely

explained

by

their

childhood

disadvantages

and

subsequent

lower

socioeconomic

status

and

poorer

health

in

adulthood

compared

to

whites

All

three

of

our

hypotheses

are

supported

We

find

that

blacks

suffer

from

a

higher

risk

of

moderatesevere

cognitive

impairment

both

at

baseline

and

during

the

followup

Hypothesis

Our

findings

are

consistent

with

most

of

the

previous

studies

on

racial

differences

in

dementia

or

Alzheimers

disease

based

on

regional

and

nonrepresentative

samples

eg

Demirovic

et

al

Tang

et

al

Yaffe

et

al

As

expected

we

find

that

blacks

are

more

likely

to

report

childhood

adversity

than

whites

and

to

have

grown

up

in

the

segregated

South

and

these

earlylife

adversities

put

them

at

a

significantly

higher

risk

of

cognitive

impairment

in

later

life

The

racial

gap

is

reduced

after

the

adjustment

of

childhood

conditions

Hypothesis

Thus

our

results

suggest

that

the

racial

gap

in

cognitive

impairment

can

be

explained

in

part

by

the

racial

difference

in

childhood

conditions

As

for

hypothesis

we

find

that

adulthood

SES

educational

attainment

in

particular

is

associated

with

the

risk

of

cognitive

impairment

net

of

childhood

conditions

and

the

wide

gap

in

adulthood

SES

between

older

blacks

and

whites

accounts

for

a

significant

part

of

the

racial

gap

in

cognitive

impairment

In

addition

once

childhood

conditions

and

adulthood

SES

are

controlled

for

racial

differences

in

adult

health

and

health

behavior

explain

very

little

of

the

remaining

differences

between

blacks

and

whites

although

health

and

health

behaviors

are

associated

with

cognitive

impairment

Taken

together

we

contribute

to

the

ongoing

debate

on

racial

differences

in

cognitive

aging

by

providing

evidence

from

a

national

longitudinal

data

set

that

there

is

a

gap

in

the

onset

of

moderatesevere

cognitive

impairment

between

older

blacks

and

whites

Furthermore

our

results

point

to

racial

differences

in

childhood

social

and

economic

adversity

and

adulthood

SES

as

major

pathways

through

which

racial

gap

in

cognitive

impairment

is

produced

Our

results

provide

support

for

the

recent

findings

of

the

effects

of

lifecourse

SES

education

literacy

income

and

financial

adequacy

on

blackwhite

disparities

in

more

serious

cognitive

impairment

such

as

dementia

from

Shadlen

et

al

Yaffe

et

al

In

this

research

we

pay

careful

attention

to

the

longitudinal

attrition

through

mortality

and

nonresponse

by

employing

competingrisks

models

One

of

the

important

findings

is

that

those

who

used

proxies

are

a

very

disadvantaged

group

of

people

who

not

only

have

higher

risks

of

cognitive

impairment

and

mortality

but

also

are

more

likely

to

drop

out

Since

blacks

are

more

likely

to

have

proxy

respondents

studies

that

exclude

proxy

interviews

may

underestimate

racial

differences

in

cognitive

impairment

The

present

study

has

several

strengths

including

the

use

of

a

nationally

representative

data

set

the

followup

of

blacks

and

whites

to

study

the

onset

of

moderatesevere

cognitive

impairment

the

exploration

of

both

childhood

and

adulthood

conditions

as

pathways

to

the

racial

gap

in

cognitive

impairment

the

rich

measures

of

adulthood

socioeconomic

resources

and

the

inclusion

of

both

self

and

proxy

respondents

However

researchers

should

consider

several

limitations

when

interpreting

our

results

First

it

is

important

to

emphasize

that

the

medical

diagnosis

of

cognitive

impairment

often

relies

on

a

comprehensive

clinical

evaluation

and

using

cognitive

tests

and

proxy

respondents

Crimmins

et

al

Previous

research

also

showed

that

cognitive

tests

used

in

large

population

surveys

had

the

best

screening

accuracy

when

they

were

used

to

differentiate

the

demented

from

the

nondemented

Crimmins

et

al

Manly

et

al

Therefore

in

this

study

we

focused

on

the

moderatelyseverely

cognitively

impaired

and

tried

to

minimize

the

danger

of

misclassification

We

also

acknowledge

that

respondents

education

level

and

the

quality

of

education

they

receive

in

particular

may

influence

their

performance

on

the

cognitive

tests

A

related

challenge

is

whether

communitybased

screening

tools

for

cognitive

impairment

and

dementia

including

cognitive

tests

and

informant

reports

of

cognitive

function

operate

differently

for

blacks

and

whites

due

to

unmeasured

educational

and

cultural

factors

and

whether

different

cutoff

points

should

be

established

for

older

blacks

and

whites

Glymour

and

Manly

Manly

Potter

et

al

We

were

unable

to

address

these

issues

in

our

paper

due

to

the

lack

of

clinical

data

on

cognitive

impairment

in

the

HRS

Future

research

should

collect

more

clinical

data

and

produce

screening

instruments

that

take

into

consideration

the

quality

of

education

the

respondents

have

received

eg

literacy

and

the

different

cultural

attitudes

toward

cognitive

impairment

as

recent

studies

show

that

black

informants

may

be

less

likely

to

report

mild

cognitive

change

Burns

et

al

Potter

et

al

Second

although

we

are

able

to

examine

childhood

conditions

as

one

of

the

major

pathways

through

which

racial

differences

are

produced

our

measures

of

childhood

conditions

are

based

on

retrospective

selfreports

As

in

other

studies

that

have

used

retrospective

reports

eg

Hayward

and

Gorman

Luo

and

Waite

there

is

the

potential

problem

of

recall

bias

Third

our

measures

of

childhood

conditions

are

limited

and

future

research

should

tap

into

potential

racial

differences

in

childhood

nutrition

and

growth

childhood

trauma

and

maltreatment

such

as

abuse

neglect

discrimination

and

family

stressors

such

as

parental

conflicts

and

parental

loss

Barnes

et

al

Dik

et

al

Shonkoff

and

Garner

which

may

contribute

to

racial

differences

in

cognitive

impairment

Fourth

recent

studies

showed

that

social

relationship

and

emotional

support

in

adulthood

may

protect

against

cognitive

decline

Ellwardta

et

al

Hakansson

et

al

and

therefore

documented

racial

differences

in

marital

status

kin

support

and

relationship

quality

Bulanda

and

Brown

Sarkisian

and

Gerstel

may

be

another

important

pathway

to

racial

differences

in

cognitive

impairment

Last

due

to

racism

and

residential

segregation

blacks

are

more

likely

to

live

in

neighborhoods

characterized

by

poverty

social

disorder

and

exposure

to

environmental

toxins

Aneshensel

et

al

Williams

and

Sternthal

Future

research

needs

to

examine

how

different

quality

of

living

environment

of

blacks

and

whites

contributes

to

racial

differences

in

cognitive

impairment

as

recent

research

suggested

that

neighborhood

disadvantage

may

influence

cognitive

health

in

later

life

through

their

effects

on

individuals

psychological

stress

health

health

behaviors

and

access

to

resources

Aneshensel

et

al

Wu

Prina

and

Brayne

Despite

these

limitations

our

study

makes

contributions

to

the

current

discussion

on

racial

disparities

in

cognitive

impairment

by

investigating

the

issue

with

a

nationally

representative

longitudinal

data

set

Although

our

models

do

not

fully

explain

blacks

higher

risk

of

cognitive

impairment

compared

to

whites

our

results

suggest

that

earlylife

disadvantages

experienced

by

blacks

contribute

to

their

lower

socioeconomic

status

in

adulthood

which

significantly

increases

their

risk

of

cognitive

impairment

in

later

life

Reducing

racial

disparities

in

health

is

a

national

policy

priority

and

a

great

deal

of

effort

has

been

devoted

to

improving

health

care

access

advocating

positive

health

behaviors

Go

to

Biographies

Zhenmei

Zhang

is

an

associate

professor

of

sociology

at

Michigan

State

University

Her

research

interests

include

racial

and

ethnic

disparities

in

health

family

dynamics

and

health

in

later

life

the

influence

of

early

life

environment

on

cognitive

aging

and

health

disparities

in

China

Her

recent

project

supported

by

the

National

Institute

on

Aging

investigates

racial

differences

in

cognitive

impairment

among

older

Americans

Her

articles

have

appeared

in

Social

Science

and

Medicine

Journal

of

Gerontology

Social

Sciences

Journal

of

Marriage

and

Family

Research

on

Aging

and

other

journals

Mark

D

Hayward

is

Professor

of

Sociology

and

Centennial

Commission

Professor

in

the

Liberal

Arts

at

the

University

of

Texas

at

Austin

Currently

he

is

coPI

of

an

NIA

supported

research

network

on

health

dynamics

and

disparities

over

the

life

course

His

recent

work

examines

the

role

of

educational

attainment

in

the

context

of

the

life

course

in

influencing

adult

health

and

mortality

and

historical

changes

in

these

processes

YanLiang

Yu

is

a

doctoral

student

in

the

Department

of

Sociology

at

Michigan

State

University

His

research

focuses

on

health

disparities

and

particularly

how

marital

experiences

influence

health

over

the

life

course

His

recent

work

examines

the

effects

of

interracial

marriage

on

health

His

dissertation

explores

how

marital

biography

influences

the

progression

of

chronic

diseases

among

older

Americans

Go

to

Footnotes

This

study

was

supported

by

the

National

Institute

on

Aging

grant

to

Zhenmei

Zhang

the

National

Institute

of

Child

Health

and

Human

Development

grant

to

the

University

of

Texas

at

Austin

Mark

Hayward

PI

and

grant

We

are

grateful

for

comments

from

the

three

anonymous

reviewers

the

editor

and

the

participants

at

the

workshop

on

the

LongRun

Impacts

of

Early

Life

Events

IV

Evidence

from

Developed

and

Developing

Economies

Go

to

Contributor

Information

Zhenmei

Zhang

Michigan

State

University

East

Lansing

MI

USA

Mark

D

Hayward

University

of

Texas

at

Austin

Austin

TX

USA

YanLiang

Yu

Michigan

State

University

East

Lansing

MI

USA

Go

to

References

Aggarwal

Neelum

T

Wilson

Robert

S

Beck

Todd

L

Rajan

Kumar

B

Mendes

de

Leon

Carlos

F

Evans

Denis

A

EversonRose

Susan

A

Perceived

Stress

and

Change

in

Cognitive

Function

among

Adults

Years

and

Older

Psychosomatic

Medicine

PMC

free

article

PubMed

Alley

Dawn

Suthers

Kristen

Crimmin

Eileen

Education

and

Cognitive

Decline

in

Older

Americans

Result

from

the

AHEAD

Sample

Research

on

Aging

PMC

free

article

PubMed

Alzheimers

Association

AfricanAmericans

and

Alzheimers

Disease

The

Silent

Epidemic

Chicago

IL

Alzheimers

Association

Retrieved

June

httpwwwalzorgnationaldocumentsreport_africanamericanssilentepidemicpdf

Alzheimers

Association

Alzheimers

Disease

Facts

and

Figures

Chicago

IL

Alzheimers

Association

Retrieved

June

Aneshensel

Carol

S

Ko

Michelle

J

Chodosh

Joshua

Wight

Richard

G

The

Urban

Neighborhood

and

Cognitive

Functioning

in

Late

Middle

Age

Journal

of

Health

and

Social

Behavior

PMC

free

article

PubMed

Barnes

Lisa

L

Wilson

Robert

S

Everson

Rose

Susan

A

Hayward

Mark

D

Evans

Denis

A

de

Leon

Carlos

Mendes

Effects

of

EarlyLife

Adversity

on

Cognitive

Decline

in

Older

African

Americans

and

Whites

Neurology

PMC

free

article

PubMed

Bulanda

Jennifer

Roebuck

Brown

Susan

L

RaceEthnic

Differences

in

Marital

Quality

and

Divorce

Social

Science

Research

Burns

Robert

Nichols

Linda

O

Graney

Marshall

J

MartindaleAdams

Jennifer

Lummus

Allan

Cognitive

Abilities

of

Alzheimers

Patients

Perceptions

of

Black

and

White

Caregivers

The

International

Journal

of

Aging

and

Human

Development

PubMed

Ceci

Stephen

J

How

Much

Does

Schooling

Influence

General

Intelligence

and

Its

Cognitive

Components

A

Reassessment

of

the

Evidence

Developmental

Psychology

Chiao

Chi

Botticello

Amanda

Fuh

JongLing

LifeCourse

SocioEconomic

Disadvantage

and

LateLife

Cognitive

Functioning

in

Taiwan

Results

from

a

National

Cohort

Study

International

Health

PubMed

Choudhury

Sharmila

Racial

and

Ethnic

Differences

in

Wealth

and

Asset

Choices

Social

Security

Bulletin

Retrieved

June

PubMed

Colen

Cynthia

G

Addressing

Racial

Disparities

in

Health

Using

Life

Course

Perspectives

Du

Bois

Review

Social

Science

Research

on

Race

Costa

Dora

L

Race

and

Pregnancy

Outcomes

in

the

Twentieth

Century

A

LongTerm

Comparison

The

Journal

of

Economic

History

Crimmins

Eileen

M

Kim

Jung

Ki

Langa

Kenneth

M

Weir

David

R

Assessment

of

Cognition

Using

Surveys

and

Neuropsychological

Assessment

The

Health

and

Retirement

Study

and

the

Aging

Demographics

and

Memory

Study

The

Journals

of

Gerontology

Series

B

Psychological

Sciences

and

Social

Sciences

PMC

free

article

PubMed

Cutler

David

M

LlerasMuney

Adriana

Understanding

Differences

in

Health

Behaviors

by

Education

Journal

of

Health

Economics

PMC

free

article

PubMed

Deary

Ian

J

Whiteman

Martha

C

Starr

John

M

Whalley

Lawrence

J

Fox

Helen

C

The

Impact

of

Childhood

Intelligence

on

Later

Life

Following

up

the

Scottish

Mental

Surveys

of

and

Journal

of

Personality

and

Social

Psychology

PubMed

Demirovic

Jasenka

Prineas

Ronald

Loewenstein

David

Bean

Judy

Duara

Ranjan

Sevush

Steven

Szapocznik

Jose

Prevalence

of

Dementia

in

Three

Ethnic

Groups

The

South

Florida

Program

on

Aging

and

Health

Annals

of

Epidemiology

PubMed

Dik

Miranda

G

Deeg

Dorly

JH

Visser

Marjolein

Jonker

Cees

Early

Life

Physical

Activity

and

Cognition

at

Old

Age

Journal

of

Clinical

and

Experimental

Neuropsychology

PubMed

Dubowitz

Tamara

Heron

Melonie

BasurtoDavila

Ricardo

Bird

Chloe

E

Lurie

Nicole

Escarce

José

J

RacialEthnic

Differences

in

US

Health

Behaviors

A

Decomposition

Analysis

American

Journal

of

Health

Behavior

PMC

free

article

PubMed

Ellwardt

Lea

Aartsen

Marja

Deeg

Dorly

Steverink

Nardi

Does

Loneliness

Mediate

the

Relation

between

Social

Support

and

Cognitive

Functioning

in

Later

Life

Social

Science

Medicine

PubMed

Freedman

Vicki

A

Aykan

Hakan

Martin

Linda

G

Another

Look

at

Aggregate

Changes

in

Severe

Cognitive

Impairment

Further

Investigation

into

the

Cumulative

Effects

of

Three

Survey

Design

Issues

Journal

of

Gerontology

Social

Sciences

PubMed

Fritsch

Thomas

McClendon

McKee

J

Smyth

Kathleen

A

Lerner

Alan

J

Friedland

Robert

P

Larsen

Janet

D

Cognitive

Functioning

in

Healthy

Aging

The

Role

of

Reserve

and

Lifestyle

Factors

Early

In

Life

Gerontologist

PubMed

Froehlich

Tanya

E

Bogardus

Sidney

T

Jr

Inouye

Sharon

K

Dementia

and

Race

Are

There

Differences

between

African

Americans

and

Caucasians

Journal

of

American

Geriatric

Society

PubMed

Geronimus

Arline

T

Understanding

and

Eliminating

Racial

Inequalities

in

Womens

Health

in

the

United

States

The

Role

of

the

Weathering

Conceptual

Framework

Journal

of

the

American

Medical

Womens

Association

PubMed

Glymour

M

Maria

Avendano

Mauricio

Haas

Steven

Berkman

Lisa

F

Lifecourse

Social

Conditions

and

Racial

Disparities

in

Incidence

of

First

Stroke

Annals

of

Epidemiology

PMC

free

article

PubMed

Glymour

M

Maria

Manly

Jennifer

J

Lifecourse

Social

Conditions

and

Racial

and

Ethnic

Patterns

of

Cognitive

Aging

Neuropsychology

Review

PubMed

González

Hector

M

Tarraf

Wassim

Bowen

Mary

E

JohnsonJennings

Michelle

D

Fisher

Gwenith

G

What

Do

Parents

Have

to

Do

with

My

Cognitive

Reserve

Life

Course

Perspectives

on

TwelveYear

Cognitive

Decline

Neuroepidemiology

PMC

free

article

PubMed

Guyer

Bernard

Freedman

Mary

Anne

Strobino

Donna

M

Sondik

Edward

J

Annual

Summary

of

Vital

Statistics

Trends

in

the

Health

of

Americans

During

the

Century

Pediatrics

PubMed

Haas

Steven

A

The

LongTerm

Effects

of

Poor

Childhood

Health

An

Assessment

and

Application

of

Retrospective

Reports

Demography

PubMed

Hackman

Daniel

A

Farah

Martha

J

Socioeconomic

Status

and

the

Developing

Brain

Trends

in

Cognitive

Sciences

PMC

free

article

PubMed

Håkansson

Krister

Rovio

Suvi

Helkala

EevaLiisa

Vilska

AnnaRiitta

Winblad

Bengt

Soininen

Hilkka

Nissinen

Aulikki

Mohammed

Abdul

H

Kivipelto

Miia

Association

between

MidLife

Marital

Status

and

Cognitive

Function

in

Later

Life

Population

Based

Cohort

Study

Bmj

PMC

free

article

PubMed

Hayward

Mark

D

Crimmins

Eileen

M

Miles

Toni

P

Yang

Yu

The

Significance

of

Socioeconomic

Status

in

Explaining

the

Racial

Gap

in

Chronic

Health

Conditions

American

Sociological

Review

Hayward

Mark

D

Gorman

Bridget

K

The

Long

Arm

of

Childhood

The

Influence

of

Earlylife

Social

Conditions

on

Mens

Mortality

Demography

PubMed

Herzog

A

Regula

Wallace

Robert

B

Measures

of

Cognitive

Functioning

in

the

AHEAD

study

Journal

of

GerontologySocial

Sciences

PubMed

Huang

TL

Carlson

MC

Fitzpatrick

AL

Kuller

LH

Fried

LP

Zandi

PP

Knee

Height

and

Arm

Span

A

Reflection

of

Early

Life

Environment

and

Risk

of

Dementia

Neurology

PubMed

Huie

Bond

Stephanie

A

Krueger

Patrick

M

Rogers

Richard

G

Hummer

Robert

A

Wealth

Race

and

Mortality

Social

Science

Quarterly

Hummer

Robert

A

Chinn

Juanita

J

RaceEthnicity

and

US

Adult

Mortality

Progress

Prospects

and

New

Analyses

Du

Bois

Review

Social

Science

Research

on

Race

PMC

free

article

PubMed

Jefferson

Angela

L

Gibbons

Laura

E

Rentz

Dorene

M

Carvalho

Janessa

O

Manly

Jennifer

Bennett

David

A

Jones

Richard

N

A

Life

Course

Model

of

Cognitive

Activities

Socioeconomic

Status

Education

Reading

Ability

and

Cognition

Journal

of

the

American

Geriatrics

Society

PMC

free

article

PubMed

Johansson

Lena

Guo

Xinxin

Waern

Margda

Östling

Svante

Gustafson

Deborah

Bengtsson

Calle

Skoog

Ingmar

Midlife

Psychological

Stress

and

Risk

of

Dementia

A

Longitudinal

Population

Study

Brain

PubMed

Kahn

Joan

R

Pearlin

Leonard

I

Financial

Strain

over

the

Life

Course

and

Health

among

Older

Adults

Journal

of

Health

and

Social

Behavior

PubMed

Karp

Anita

Kåreholt

Ingemar

Qiu

Chengxuan

Bellander

Tom

Winblad

Bengt

Fratiglioni

Laura

Relation

of

Education

and

OccupationBased

Socioeconomic

Status

to

Incident

Alzheimers

Disease

American

Journal

of

Epidemiology

PubMed

Kuh

Diana

A

Life

Course

Approach

to

Healthy

Aging

Frailty

and

Capability

Journal

of

GerontologyMedical

Sciences

PubMed

Kurian

Anita

K

Cardarelli

Kathryn

M

Racial

and

Ethnic

Differences

in

Cardiovascular

Disease

Risk

Factors

A

Systematic

Review

Ethnicity

Disease

PubMed

Langa

Kenneth

M

Chernew

Michael

E

Kabeto

Mohammed

U

Regula

Herzog

A

Ofstedal

Mary

Beth

Willis

Robert

J

Wallace

Robert

B

Mucha

Lisa

M

Straus

Walter

L

Mark

Fendrick

A

National

Estimates

of

the

Quantity

and

Cost

of

Informal

Caregiving

for

the

Elderly

with

Dementia

Journal

of

General

Internal

Medicine

PMC

free

article

PubMed

Langa

Kenneth

M

Larson

Eric

B

Karlawish

Jason

H

Cutler

David

M

Kabeto

Mohammed

U

Kim

Scott

Y

Rosen

Allison

B

Trends

in

the

Prevalence

and

Mortality

of

Cognitive

Impairment

in

the

United

States

Is

there

Evidence

of

a

Compression

of

Cognitive

Morbidity

Alzheimers

Dementia

PMC

free

article

PubMed

LaVeist

Thomas

A

Thorpe

Roland

J

Jr

Galarraga

Jessica

E

Bower

Kelly

M

GaryWebb

Tiffany

L

Environmental

and

SocioEconomic

Factors

as

Contributors

to

Racial

Disparities

in

Diabetes

Prevalence

Journal

of

General

Internal

Medicine

PMC

free

article

PubMed

Lee

Everett

S

Negro

Intelligence

and

Selective

Migration

A

Philadelphia

Test

of

the

Klineberg

Hypothesis

American

Sociological

Review

Lee

Yunhwan

Back

Joung

Hwan

Kim

Jinhee

Kim

SiHeon

Duk

L

Cheong

HaeKwan

Hong

Chang

Hyung

Kim

Youn

Gu

Systematic

Review

of

Health

Behavioral

Risks

and

Cognitive

Health

in

Older

Adults

International

Psychogeriatrics

PubMed

Lièvre

Agnès

Alley

Dawn

Crimmins

Eileen

M

Educational

Differentials

in

Life

Expectancy

with

Cognitive

Impairment

among

the

Elderly

in

the

United

States

Journal

of

Aging

and

Health

PMC

free

article

PubMed

Lin

James

C

Guerrieri

Joy

Gioia

Moore

Alison

A

Drinking

Patterns

and

the

Development

of

Functional

Limitations

in

Older

Adults

Longitudinal

Analyses

of

the

Health

and

Retirement

Survey

Journal

of

Aging

and

Health

PMC

free

article

PubMed

Luo

Ye

Waite

Linda

The

Impact

of

Childhood

and

Adult

SES

on

Physical

Mental

and

Cognitive

WellBeing

in

Later

Life

Journal

of

Gerontology

Social

Sciences

PMC

free

article

PubMed

Lupien

Sonia

J

McEwen

Bruce

S

Gunnar

Megan

R

Heim

Christine

Effects

of

Stress

throughout

the

Lifespan

on

the

Brain

Behaviour

and

Cognition

Nature

Reviews

Neuroscience

PubMed

Lynch

John

W

Kaplan

George

A

Shema

Sarah

J

Cumulative

Impact

of

Sustained

Economic

Hardship

on

Physical

Cognitive

Psychological

and

Social

Functioning

The

New

England

Journal

of

Medicine

PubMed

Manly

Jennifer

J

Advantages

and

Disadvantages

of

Separate

Norms

for

African

Americans

Clinical

Neuropsychologist

PubMed

Manly

Jennifer

J

Schupf

Nichole

Stern

Yaakov

Brickman

Adam

M

Tang

MingX

Mayeux

Richard

TelephoneBased

Identification

of

Mild

Cognitive

Impairment

and

Dementia

in

a

Multicultural

Cohort

Archives

of

Neurology

PMC

free

article

PubMed

Manly

Jennifer

J

Mayeux

Richard

Ethnic

Differences

in

Dementia

and

Alzheimers

Disease

In

Anderson

NB

Bulatao

RA

Cohen

B

editors

Critical

Perspectives

on

Racial

and

Ethnic

Differences

in

Health

in

Late

Life

Washington

DC

The

National

Academies

Press

pp

Melrose

Rebecca

J

Brewster

Paul

Marquine

María

J

MacKayBrandt

Anna

Reed

Bruce

Farias

Sarah

T

Mungas

Dan

Early

Life

Development

in

a

Multiethnic

Sample

and

the

Relation

to

Late

Life

Cognition

Journal

of

GerontologyPsychological

Sciences

PMC

free

article

PubMed

Mensah

George

A

Mokdad

Ali

H

Ford

Earl

S

Greenlund

Kurt

J

Croft

Janet

B

State

of

Disparities

in

Cardiovascular

Health

in

the

United

States

Circulation

PubMed

Moceri

VM

Kukull

WA

Emanuel

I

van

Belle

G

Larson

EB

EarlyLife

Risk

Factors

and

the

Development

of

Alzheimers

Disease

Neurology

PubMed

Montez

Jennifer

K

Hayward

Mark

D

Cumulative

Childhood

Adversity

Educational

Attainment

and

Active

Life

Expectancy

among

US

Adults

Demography

PMC

free

article

PubMed

Ofstedal

Mary

Beth

Fisher

Gwenith

G

Regula

Herzog

A

Documentation

of

Cognitive

Functioning

Measures

in

the

Health

and

Retirement

Study

HRS

Documentation

Report

Retrieved

May

ORand

Angela

M

HamilLuker

Jenifer

Processes

of

Cumulative

Adversity

Childhood

Disadvantage

and

Increased

Risk

of

Heart

Attack

across

the

Life

Course

Journal

of

Gerontology

Social

Sciences

PubMed

Pavalko

Eliza

K

Caputo

Jennifer

Social

Inequality

and

Health

across

the

Life

Course

American

Behavioral

Scientist

Peters

Ruth

Peters

Jean

Warner

James

Beckett

Nigel

Bulpitt

Christopher

Alcohol

Dementia

and

Cognitive

Decline

in

the

Elderly

A

Systematic

Review

Age

and

ageing

PubMed

Plassman

BL

Langa

KM

Fisher

GG

Heeringa

SG

Weir

DR

Ofstedal

MB

Burke

JR

Hurd

MD

Potter

GG

Rodgers

WL

Steffens

DC

Willis

RJ

Wallace

RB

Prevalence

of

Dementia

in

the

United

States

The

Aging

Demographics

and

Memory

Study

Neuroepidemiology

PMC

free

article

PubMed

Plassman

Brenda

L

Langa

Kenneth

M

Fisher

Gwenith

G

Heeringa

Steven

G

Weir

David

R

Ofstedal

Mary

Beth

Burke

James

R

Hurd

Michael

D

Potter

Guy

G

Rodgers

Willard

L

Steffens

David

C

McArdle

John

J

Willis

Robert

J

Wallace

Robert

B

Prevalence

of

Cognitive

Impairment

without

Dementia

in

the

United

States

Annals

of

Internal

Medicine

PMC

free

article

PubMed

Pollack

Craig

Evan

Chideya

Sekai

Cubbin

Catherine

Williams

Brie

Dekker

Mercedes

Braveman

Paula

Should

Health

Studies

Measure

Wealth

A

Systematic

Review

American

Journal

of

Preventive

Medicine

PubMed

Potter

Guy

G

Plassman

Brenda

L

Burke

James

R

Kabeto

Mohammed

U

Langa

Kenneth

M

Llewellyn

David

J

Rogers

Mary

AM

Steffens

David

C

Cognitive

Performance

and

Informant

Reports

in

the

Diagnosis

of

Cognitive

Impairment

and

Dementia

in

African

Americans

and

Whites

Alzheimers

and

Dementia

PMC

free

article

PubMed

Reuser

Mieke

Willekens

Frans

J

Bonneux

Luc

Higher

Education

Delays

and

Shortens

Cognitive

Impairment

A

Multistate

Life

Table

Analysis

of

the

US

Health

and

Retirement

Study

European

Journal

of

Epidemiology

PMC

free

article

PubMed

Richards

Marcus

Shipley

Beverly

Fuhrer

Rebecca

Wadsworth

Michael

E

Cognitive

Ability

in

Childhood

and

Cognitive

Decline

in

Midlife

Longitudinal

Birth

Cohort

Study

Bmj

PMC

free

article

PubMed

Sarkisian

Natalia

Gerstel

Naomi

Kin

Support

Among

Blacks

and

Whites

Race

and

Family

Organization

American

Sociological

Review

Scazufca

Marcia

Menezes

Paulo

R

Araya

Ricardo

Di

Rienzo

Vanessa

D

Almeida

Osvaldo

P

Gunnell

David

Lawlor

Debbie

A

Risk

Factors

across

the

Life

Course

and

Dementia

in

a

Brazilian

Population

Results

from

the

Sao

Paulo

Ageing

Health

Study

SPAH

International

Journal

of

Epidemiology

PubMed

Schooler

Carmi

Cognitive

Effects

of

Complex

Environments

during

the

Life

Span

A

Review

and

Theory

In

Schooler

C

Schaie

KW

editors

Cognitive

Functioning

and

Social

Structure

over

the

Life

Course

Norwood

NJ

Ablex

pp

Shadlen

MarieFlorence

Siscovick

David

Fitzpatrick

Annette

L

Dulberg

Corinne

Kuller

Lewis

H

Jackson

Sharon

Education

Cognitive

Test

Scores

and

BlackWhite

Differences

in

Dementia

Risk

Journal

of

the

American

Geriatrics

Society

PubMed

Shapiro

Thomas

M

Meschede

Tatjana

Sullivan

Laura

Research

and

Policy

Brief

Institute

on

Assets

and

Social

Policy

Brandeis

University

The

Racial

Wealth

Gap

Increases

Fourfold

Shonkoff

Jack

P

Garner

Andrew

S

The

Lifelong

Effects

of

Early

Childhood

Adversity

and

Toxic

Stress

Pediatrics

PubMed

SinghManoux

Archana

Marmot

Michael

High

Blood

Pressure

Was

Associated

with

Cognitive

Function

in

MiddleAge

in

the

Whitehall

II

Study

Journal

of

Clinical

Epidemiology

PubMed

Smith

James

P

Reconstructing

Childhood

Health

Histories

Demography

PMC

free

article

PubMed

Tang

MX

Cross

P

Andrews

H

Jacobs

DM

Small

S

Bell

K

Merchant

C

Lantigua

R

Costa

R

Stern

Y

Mayeux

R

Incidence

of

AD

in

AfricanAmericans

Caribbean

Hispanics

and

Caucasians

in

Northern

Manhattan

Neurology

PubMed

Taylor

Donald

H

Jr

Sloan

Frank

A

Murali

Doraiswamy

P

Marked

Increase

in

Alzheimers

Disease

Identified

in

Medicare

Claims

Records

between

and

Journal

of

Gerontology

Medical

Sciences

PubMed

Tilvis

Reijo

S

KähönenVäre

Mervi

H

Jolkkonen

Juha

Valvanne

Jaakko

Pitkala

Kaisu

H

Strandberg

Timo

E

Predictors

of

Cognitive

Decline

and

Mortality

of

Aged

People

over

a

Period

Journal

of

GerontologyMedical

Sciences

PubMed

Turrell

Gavin

Lynch

John

W

Kaplan

George

A

Everson

Susan

A

Helkala

EevaLiisa

Kauhanen

Jussi

Salonen

Jukka

T

Socioeconomic

Position

across

the

Lifecourse

and

Cognitive

Function

in

Late

Middle

Age

Journal

of

Gerontology

Social

Sciences

PubMed

Warner

David

F

Hayward

Mark

D

EarlyLife

Origins

of

the

Race

Gap

in

Mens

Mortality

Journal

of

Health

and

Social

Behavior

PubMed

Whalley

LJ

Starr

JM

Athawes

R

Hunter

D

Pattie

A

Deary

IJ

Childhood

Mental

Ability

and

Dementia

Neurology

PubMed

Williams

David

R

Sternthal

Michelle

Understanding

RacialEthnic

Disparities

in

Health

Sociological

Contributions

Journal

of

Health

and

Social

Behavior

PMC

free

article

PubMed

Wimo

Anders

Winblad

Bengt

Jönsson

Linus

The

Worldwide

Societal

Costs

of

Dementia

Estimates

for

Alzheimers

and

Dementia

PubMed

Wu

YuTzu

Matthew

Prina

A

Brayne

Carol

The

Association

between

Community

Environment

and

Cognitive

Function

A

Systematic

Review

Social

Psychiatry

and

Psychiatric

Epidemiology

PMC

free

article

PubMed

Yaffe

Kristine

Falvey

Cherie

Harris

Tamara

B

Newman

Anne

Satterfield

Suzanne

Koster

Annemarie

Ayonayon

Hilsa

Simonsick

Eleanor

Effect

of

Socioeconomic

Disparities

on

Incidence

of

Dementia

among

Biracial

Older

Adults

Prospective

Study

Bmj

PMC

free

article

PubMed

Zhang

Zhenmei

Hayward

Mark

D

Gender

the

Marital

Life

Course

and

Cardiovascular

Health

in

Late

Midlife

Journal

of

Marriage

and

Family

Zhang

Zhenmei

Gu

Danan

Hayward

Mark

D

Early

Life

Influences

on

Cognitive

Impairment

among

Oldest

Old

Chinese

Journal

of

Gerontology

Social

Sciences

PubMed

Zhang

Zhenmei

Gu

Danan

Hayward

Mark

D

Childhood

Nutritional

Deprivation

and

Cognitive

Impairment

among

Older

Chinese

Social

Science

and

Medicine

PMC

free

article

PubMed

Zsembik

Barbara

A

Kristen

Peek

M

Race

Differences

in

Cognitive

Functioning

among

Older

Adults

Journal

of

GerontologySocial

Sciences

PubMed

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Palmar crease variants and their clinical significance a study of newborns at risk Adult Age Factors Child Child Preschool Continental Population Groups Dermatoglyphics Down Syndromediagnosis Female Fetusdrug effects Hand Humans Infant Newborn Infant Newborn Diseasesdiagnosis Infant Premature Infant Small for Gestational Age Male MaternalFetal Exchange Methadoneadverse effects Pregnancy Pregnancy Complications Risk Sex Factors

B O O O O B I O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Ionizing radiation the good the bad and the ugly Ryan JL1 Author information 1Departments of Dermatology and Radiation Oncology Center for Medical Countermeasures against Radiation University of Rochester Medical Center Rochester New York 14642 USA Julie_Ryanurmcrochesteredu Skin changes caused by ionizing radiation have been scientifically documented since 1902 Ionizing radiation is a widely accepted form of treatment for various types of cancer Despite the technological advances radiation skin injury remains a significant problem This injury often referred to as radiation dermatitis occurs in about 95 of patients receiving radiation therapy for cancer and ranges in severity from mild erythema to moist desquamation and ulceration Ionizing radiation is not only a concern for cancer patients but also a public health concern because of the potential for and reality of a nuclear andor radiological event Recently the United PMCID PMC3779131 PMID 22217743 Publication Types Review MeSH terms Dermatitisetiology Dermatitisimmunology Dermatitispathology Humans Radiation Injuriescomplications Radiation Injuriesimmunology Radiation Injuriespathology Radiation Ionizing Radiotherapyadverse effects Skinimmunology Skinradiation effects Terrorism Grant support R25 CA102618CANCI NIH HHSUnited States U10 CA037420CANCI NIH HHSUnited States

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Home About People Staff Directory Board of Directors Staff Directory Sustainers Staff Directory Lynn Brinkley Sustainability Assistant ext 102 Lynn joined the Centers sustainability team in 2017 to assist with managing data administering resource development events and promoting direct marketing opportunities for donors Since 2010 she has volunteered interned and worked at a variety of nonprofits ranging in size and focus She attended the University of North Carolina at Greensboro and American University in DC for degrees in social science and policy In her spare time she enjoys cooking fromscratch and reading nonfiction Tammy Bromley Program Administrative Assistant ext 100 Tammy provides support to the president and CEO and handles other administrative duties including initial points of communication Shes been in the nonprofit sector for 15 years in staff and volunteer positions A native of North Carolina Tammy enjoys spending time with her two grown kids friends and her various pets Bridgette Burge Director of Programs ext 115 Bridgette manages the NC Centers learning opportunities including webinars workshops and special projects She also supports many of the Centers collaborations with capacitybuilders and partner nonprofits She has more than two decades of nonprofit experience serving as a board member executive director fundraiser program manager and volunteer Bridgette earned her bachelors degree from Rhodes College her masters from the University of Memphis and a nonprofit management certificate from Duke University She loves living in Raleigh with her partner their two children and their goofy rescue beagle Tracy Careyette Chief Financial Officer ext Tracy is responsible for the overall financial operations of the Center as well as audit and tax functions budgeting policies and procedures and human resources She began working at the Center as an intern while attending Meredith College where she received a BA in mathematics with a minor in accounting An 18year veteran of the Center she has more than 12 years experience in nonprofit accounting and human resource management Previously she worked as a staff accountant with a CPA firm specializing in nonprofit accounting and financial consulting She currently serves on the NotforProfit Committee of the NC Association of Sarah Easley Events Coordinator ext 126 Sarah plans coordinates and implements the Centers conference Nonprofit Town Halls and other events A southcentral Virginia native she holds a BA in political science from the University of South Carolina In her free time Sarah enjoys group exercise classes road trips to visit friends family and her beagle Annie and cheering on her beloved South Carolina Gamecocks David Heinen Vice President for Public Policy and Advocacy ext 111 David advocates on issues affecting NCs nonprofit sector monitors and analyzes state and federal public policy issues keeps nonprofits and media across NC informed about important legal and policy developments engages in research about the sector provides training on advocacy and legal compliance and convenes coalitions of nonprofits from diverse fields He joined the Center in 2007 Previously David was an attorney with Dorn Klamp PC a Washington DC law firm serving nonprofits He has served on the boards of local and national nonprofits and currently serves on the board of Nonprofit VOTE and on the public policy committee of Rob Maddrey Director for Sustainability ext 117 Rob is responsible for raising the financial resources which support the work of the Center Rob brings more than 29 years experience in nonprofit leadership Previously he was assistant vice president for philanthropy annual fund and operations with the NC Symphony He was director of communications for Preservation North Carolina managing their annual conference and communications Rob was the first executive director of ARTS North Carolina and successfully consolidated Arts Advocates of North Carolina a statewide advocacy organization into ARTS North Carolina in 1996 he went on to lead it for two more years He currently serves on the board Caroline McDowell Marketing Communications Manager ext 113 Caroline coordinates and manages the marketing and communications for the Centers programs and initiatves She has been with the Center for more than nine years in an evolution of roles from administrative support to her current position Previously she worked with the City of Chesterfield MO Three Rivers Young Peoples Orchestras and the Pittsburgh TribuneReview She earned a BA in creative writing and communications from the University of Pittsburgh Caroline and her family enjoy having the mountains in one direction and the beach in the other Katrina Pareja Member Services Assistant ext 101 Katrina is responsible for supporting member services by working to retain and serve the Members of the Center She attended NCSU where she obtained a bachelors in sociology with a minor in nonprofit studies Katrina volunteers with agencies serving individuals and families experiencing hunger and homelessness In her free time she enjoys traveling attending music events and spending time with her lovable miniature dachshund Chip Jeanne Tedrow President CEO ext Jeanne comes to the Center after 25 years with Passage Home a community development corporation she cofounded and grew from helping a couple of families a year to one that serves over a thousand individuals leveraging 38 million of housing and support services annually in Wake County She has served on boards and committees throughout the Triangle and statewide and has been recognized with awards such as the Pro Ecclesia Et Pontifices bestowed and blessed by the Pope in the 2000 Jubilee Year TBJs 2017 Women In Business and named a 2015 Goodmon Fellow She earned a BA in urban Salima Thomas Director of Member Engagement ext 114 Salima facilitates membership efforts including Member assistance and Member relations She has nonprofit experience serving as a volunteer trainer program manager and boardcommittee member Salima received her bachelors in music education from UNCGreensboro and masters in public administration with concentrations in arts administration and nonprofit management from UNCCharlotte In her free time she enjoys the arts traveling reading and spending time with family and friends

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Location NDSU Vice President for Finance and Administration Division of Finance and Administration NDSUs Division of Finance and Administration provides fiscal and administrative counsel to the executive offices of the University assuring that the institution operates within the legal and regulatory parameters of the State Board of Higher Education and the North Dakota University System We provide human resources services fiscal management coordination of Universitywide planning institutional budgeting and policy analysis The Division is responsible for maintaining the physical campus environment and ensuring the safety of faculty students and staff The Division also oversees the institutions selfsustaining auxiliary services departments Division of Finance and Administration Structure The Division of Finance and Administration coordinates the efforts of all auxiliary facilities financial and operational business functions across campus View the VPFA Org Chart Auxiliary Operations Employee Services Facilities Management Finance Institutional Budgeting University Police and Safety Office Mission Finance and Administration is a critical pillar of the University providing supportive learning and partnership Vision Finance and Administration strives to be a resourceful partner by providing direct and advisory services while promoting accountability to the University and its extended community Core Values Our division is committed to excellence and we demonstrate that through our innovative problem solving cooperative relationships and focus on customer service Bruce A Bollinger Vice President for Finance and Administration Phone 701 2318412 BruceBollingerndsuedu VPFA Office Phone 701 2318411 Fax 701 2316194 ndsuvpfandsuedu Hours 800 500 pm 730 400 pm SummerBreaks Mailing Address NDSU Dept 3000 PO Box 6050 Fargo ND 581086050 Campus Address Map Old Main 11 1340 Administration Avenue Fargo ND 58102 Vice President for Finance and Administration navigation Accountability and Student Affordability Budget Reports Campus Master Plan Campus Space and Facilities Committee Economic Impact Reports Financial Reports Forms Fraud Hotline Policies Procedures Scholarship VPFA Annual Report VPFA Staff Auxiliary Operations Bookstore Dining Memorial Union Operations Residence Life Wellness Center Employee Services Center for Child Development Human ResourcesPayroll Facilities Management Facilities Management Facilities Operations Construction and Maintenance Parking and Transportation Services Space Management KeyCard Access Finance Accounting Customer Account Services Grant and Contract Accounting Purchasing Student Loan Service Center Institutional Budgeting Budget Office University Police and Safety Office Communications Call Center Environmental Health and Safety Public Health and Safety University Police University Police and Safety Office

O O O O O B I I O O B I I O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I O O O O O O O O O O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

finance and administration
north dakota university