Lifecourse social conditions and racial and ethnic patterns of cognitive aging

A lifecourse perspective is key for understanding and interpreting racial and ethnic patterns in neuropsychological test performance. In this article, we discuss contextual factors that shape the environmental conditions encountered by racial and ethnic minorities in the United States, in particular African-Americans. These conditions include geographic segregation at the level of regions, metropolitan areas, and neighborhoods; intra- and inter-national migration patterns; socioeconomic position, including financial resources, and occupational and educational opportunities; discrimination; and group resources. Each of these exposures sets in course a cascade of individual mediators that ultimately manifest in neuropsychological outcomes. The physiological and behavioral consequences of these pathways likely accumulate across the lifecourse. We focus on cognitive aging, although the processes discussed here begin in infancy and likely influence cognitive outcomes throughout life from childhood into old age. A lifecourse framework can help inform clinical encounters, neuropsychological research, and surveillance regarding the population prevalence of cognitive impairments.