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Education, cognitive test scores, and black-white differences in dementia risk
Shadlen MF, Siscovick D, Fitzpatrick AL, Dulberg C, Kuller LH, Jackson S.. Journal of the American Geriatrics Society, 2006-06-01
Topic: Risk, prevention and care in population studies
Objectives To compare dementia risks of elderly black and white subjects and to determine whether differences in education and cognitive test scores contribute to the inconsistency in reported differences between these groups. Design Longitudinal, 6-year follow-up. Participants Two thousand seven hundred eighty-six older black and white subjects in the Cardiovascular Health Study. Measurements Age, education (>10 years vs 85). Potential confounders were sex, depression, apolipoprotein E4 genotype, vascular disease, and baseline magnetic resonance imaging changes. Results White subjects with low education and black subjects with high education had twice the risk of dementia of white subjects with high education (95% confidence interval (CI)=1.5-2.4 and 95% CI=1.4-2.7); black subjects with low education had five times the risk of dementia (95% CI=3.4-7.7). Likewise, for subjects with low 3MSE scores, black subjects had 6.7 times the risk of dementia (95% CI=4.7-9.7) and white subjects had 2.7 times the risk of dementia (95% CI=2.2-3.5) as white subjects with high 3MSE scores. Finally, in Cox models, there was no significant black-white difference in dementia risk after adjustment for all confounders and baseline 3MSE. Conclusion Black race was associated with greater dementia risk even after adjustment for education and other potential confounders. This black-white difference in dementia risk was markedly attenuated after adjustment for baseline cognitive screening scores. The apparent race effect may reflect gaps in the quality of education or differences in the trajectory of impaired cognitive function experienced by the two groups. Future investigations might take these findings into consideration for the design of studies evaluating black-white differences in dementia risk.
Key findings
- Results White subjects with low education and black subjects with high education had twice the risk of dementia of white subjects with high education (95% confidence interval (CI)=1.5-2.4 and 95% CI=1.4-2.7); black subjects with low education had five times the risk of dementia (95% CI=3.4-7.7).
- Finally, in Cox models, there was no significant black-white difference in dementia risk after adjustment for all confounders and baseline 3MSE.
- Conclusion Black race was associated with greater dementia risk even after adjustment for education and other potential confounders.
- Future investigations might take these findings into consideration for the design of studies evaluating black-white differences in dementia risk.
Why it matters
In this longitudinal study, black race was associated with greater dementia risk even after adjusting for education and other factors, and there was no significant black-white difference after adjusting for all confounders and baseline cognitive test scores. It examines risk differences and does not test a treatment, cure or prevention.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 110 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.0 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 2 / 6 | Cited 2.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 18 other studies in this library |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Sharon Jackson: h-index 30 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16776783) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Shadlen, M. F., Siscovick, D., Fitzpatrick, A. L., Dulberg, C., Kuller, L. H., & Jackson, S. (2006). Education, cognitive test scores, and black-white differences in dementia risk. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2006.00747.x
Vancouver
Shadlen MF, Siscovick D, Fitzpatrick AL, Dulberg C, Kuller LH, Jackson S. Education, cognitive test scores, and black-white differences in dementia risk. Journal of the American Geriatrics Society. 2006. doi:10.1111/j.1532-5415.2006.00747.x. PMID: 16776783.
BibTeX
@article{shadlen2006-16776783,
author = {Shadlen, M. F. and Siscovick, D. and Fitzpatrick, A. L. and Dulberg, C. and Kuller, L. H. and Jackson, S.},
title = {{Education, cognitive test scores, and black-white differences in dementia risk}},
journal = {Journal of the American Geriatrics Society},
year = {2006},
doi = {10.1111/j.1532-5415.2006.00747.x},
pmid = {16776783},
url = {https://doi.org/10.1111/j.1532-5415.2006.00747.x}
}
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