Quality of Education and Late-Life Cognitive Function in a Population-Based Sample From Puerto Rico

We examined quality of education, literacy, and years of education in relation to late-life cognitive function and decline in older Puerto Ricans.

Our sample consisted of 3,385 community-dwelling adults aged 60 years and older from the Puerto Rican Elderly: Health Conditions study. Quality of education was based on principal component analysis of variables gathered from Department of Education and Census reports. Literacy (yes/no) and years of education were self-reported. Cognitive function was assessed in participants' homes at baseline and 4 years later using a previously validated Spanish-language 20-point global screening measure for dementia, the minimental Cabán. Regression models were adjusted for sociodemographic and life course covariates.

Quality of education was positively correlated with both educational attainment and cognitive performance. Independent of years of education, literacy, childhood economic hardship, and adult economic hardship, compared to participants in the lowest quartile of education quality, those in the highest quartile had significantly better baseline cognitive performance (β = 0.09, p < .001). Quality of education did not consistently show an association with change in cognitive function over 4 years. Literacy and greater educational attainment were each independently associated with better cognitive function at baseline and less cognitive decline.

Quality of education, literacy, and years of education, while interrelated, also show independent associations with cognitive functioning in older Puerto Ricans. The downstream factors of literacy and years of education were more closely related to age-related cognitive decline than quality of education.