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Multiple Influences on Cognitive Function Among Urban-Dwelling African Americans

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Abstract

This study examined multiple influences on cognitive function among African Americans, including education, literacy, poverty status, substance use, depressive symptoms, and cardiovascular disease (CVD) risk factors. Baseline data were analyzed from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Participants were 987 African Americans (mean age 48.5 years, SD = 9.17) who completed cognitive measures assessing verbal learning and memory, nonverbal memory, working memory, verbal fluency, perceptuo-motor speed, attention, and cognitive flexibility. Using preplanned hierarchical regression, cognitive performance was regressed on the following: (1) age, sex, education, poverty status; (2) literacy; (3) cigarette smoking, illicit substance use; (4) depressive symptoms; and (5) number of CVD risk factors. Results indicated that literacy eliminated the influence of education and poverty status in select instances, but added predictive utility in others. In fully adjusted models, results showed that literacy was the most important influence on cognitive performance across all cognitive domains (p < .001); however, education and poverty status were related to attention and cognitive flexibility. Depressive symptoms and substance use were significant predictors of multiple cognitive outcomes, and CVD risk factors were not associated with cognitive performance. Overall, findings underscore the need to develop cognitive supports for individuals with low literacy, educational attainment, and income, and the importance of treating depressive symptoms and thoroughly examining the role of substance use in this population.

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Acknowledgments

The authors wish to thank the HANDLS study participants for their contributions and the HANDLS staff for collection and availability of the data.

Funding

This research was supported by the National Institute on Aging grants (Z01–AG000194) to Evans and Zonderman (R01 AG034161) to Waldstein; the Claude D. Pepper Older Americans Independence Center (P30 AG028747) to Magaziner, Katzel, and Ryan; and the National Institute of General Medical Sciences (P20 GM103446, P20 GM113125) and the state of Delaware to Wright.

Author information

Authors and Affiliations

  1. School of Nursing, University of Delaware, Newark, DE, USA

    R. S. Wright

  2. Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA

    S. R. Waldstein, M. R. Sprung, D. L. Beatty Moody, A. D. Taylor, E. Al’Najjar & J. M. McNeely

  3. Geriatric Research Education & Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA

    S. R. Waldstein

  4. Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA

    C. S. Gerassimakis

  5. Christiana Care Value Institute, Newark, DE, USA

    Z. Zhang

  6. Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD, USA

    M. K. Evans & A. B. Zonderman

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  1. R. S. Wright
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  2. S. R. Waldstein
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  3. C. S. Gerassimakis
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  4. M. R. Sprung
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  5. D. L. Beatty Moody
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  7. E. Al’Najjar
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  8. J. M. McNeely
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  9. Z. Zhang
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  10. M. K. Evans
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  11. A. B. Zonderman
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Corresponding author

Correspondence to R. S. Wright.

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All participants provided written informed consent. The HANDLS protocol was approved by the Institutional Review Board at the National Institute of Environmental Health Sciences. Participants receive monetary compensation for their participation.

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The authors declare that they have no conflict of interest.

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Wright, R.S., Waldstein, S.R., Gerassimakis, C.S. et al. Multiple Influences on Cognitive Function Among Urban-Dwelling African Americans. J. Racial and Ethnic Health Disparities 6, 851–860 (2019). https://doi.org/10.1007/s40615-019-00584-x

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  • DOI: https://doi.org/10.1007/s40615-019-00584-x

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