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Disparities in cognitive functioning by race/ethnicity in the Baltimore Memory Study.
Brian S Schwartz1, Thomas A Glass, Karen I Bolla
1Department of Environmental Health Sciences, Division of Occupational and Environmental Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA. bschwart@jhsph.edu
Environmental Health Perspectives
|March 5, 2004
Summary
Cognitive decline differs by race, with African Americans scoring lower than whites. While socioeconomic status and health factors explain some differences, significant disparities persist, indicating complex underlying causes for cognitive differences.
Area of Science:
- Neuroscience
- Public Health
- Sociology
Background:
- Cognitive function varies by race/ethnicity, with minorities often scoring lower than whites.
- The underlying reasons for these racial/ethnic cognitive differences remain poorly understood.
- Previous studies have inconsistently controlled for confounding variables like socioeconomic status (SES), health behaviors, and environmental factors.
Purpose of the Study:
- To examine racial/ethnic differences in neurobehavioral test scores.
- To assess the impact of socioeconomic status (SES), health-related behaviors, and health conditions on these differences.
- To analyze these disparities in a cross-sectional analysis of data from the Baltimore Memory Study.
Main Methods:
- A cohort study involving randomly selected residents aged 50-70 from Baltimore neighborhoods.
- Neurobehavioral testing was administered to 1,140 participants.
- Statistical analyses adjusted for age, sex, testing technician, SES, health behaviors, health conditions, and blood lead levels.
Main Results:
- Significant differences in neurobehavioral scores existed between African Americans and whites, with African Americans scoring lower.
- Adjusting for SES reduced the score difference by 25.8%.
- Further adjustments for health factors and blood lead reduced the difference by an additional 10%, but substantial disparities (0.43 standard deviation) persisted across all cognitive domains.
Conclusions:
- Racial/ethnic differences in cognitive test scores are significant and not fully explained by SES, health behaviors, or health conditions.
- The persistent disparities suggest complex, multilevel determinants of cognitive function that warrant further investigation.
- Findings indicate potential systemic factors contributing to cognitive differences beyond individual-level variables.