Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context
Summary: Background: Despite elevated dementia risk, cognitive health among Indigenous older adults remains understudied. This study explored how modifiable factors were associated with cognitive health among Indigenous, Black, Hispanic, and White older adults. Methods: Using longitudinal panel dat...
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Elsevier
2025-10-01
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| Series: | The Lancet Regional Health. Americas |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X25002170 |
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| author | Cliff Whetung Ernest Gonzales |
| author_facet | Cliff Whetung Ernest Gonzales |
| author_sort | Cliff Whetung |
| collection | DOAJ |
| description | Summary: Background: Despite elevated dementia risk, cognitive health among Indigenous older adults remains understudied. This study explored how modifiable factors were associated with cognitive health among Indigenous, Black, Hispanic, and White older adults. Methods: Using longitudinal panel data from the Health and Retirement Study (2006–2020, N = 27,327), we estimated mixed effect growth curve models to examine associations between modifiable factors and total cognitive function. Findings: This diverse sample of Indigenous (1.65%), Black (11.43%), Hispanic (9.85%), and White (77.07%) older adults had a mean age of 61 (SD = 9.66) and was 52% female. Despite being younger on average (M = 59), 3% of Indigenous respondents reported memory-related diagnoses three times the overall sample rate. Linear mixed-effect growth curve analysis revealed that Indigenous and Black older adults had similar cognitive trajectories. A college education was a protective factor for initial cognitive function (b0 = 3.09, 95% CI: 2.91, 3.27) and over time (b = 0.24, 95% CI: 0.15, 0.33) across ethnicity. Formal (b = 0.21, 95% CI: 0.15, 0.27) and informal (b = 0.26, 95% CI: 0.20, 0.32) volunteering were associated with slower rates of cognitive decline relative to non-volunteers, though these effects may partly reflect socioeconomic status. Among Indigenous older adults, higher education, volunteering, and fewer depressive symptoms were linked to better cognitive outcomes. Interpretation: Despite high levels of resource deprivation, Indigenous older adults demonstrate resilience that supports cognitive health. Expanding access to education and volunteering in later life through targeted social policy may enhance cognitive outcomes in Indigenous communities for generations. Funding: This research was supported by the National Institute on Aging (R36AG078781). |
| format | Article |
| id | doaj-art-46c1ca3aaacf4378bcb8fe27c49ab292 |
| institution | DOAJ |
| issn | 2667-193X |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
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| series | The Lancet Regional Health. Americas |
| spelling | doaj-art-46c1ca3aaacf4378bcb8fe27c49ab2922025-08-20T03:05:30ZengElsevierThe Lancet Regional Health. Americas2667-193X2025-10-015010120710.1016/j.lana.2025.101207Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in contextCliff Whetung0Ernest Gonzales1University of Minnesota Medical School, Duluth, MN, USA; Corresponding author.New York University, Silver School of Social Work, NY, USASummary: Background: Despite elevated dementia risk, cognitive health among Indigenous older adults remains understudied. This study explored how modifiable factors were associated with cognitive health among Indigenous, Black, Hispanic, and White older adults. Methods: Using longitudinal panel data from the Health and Retirement Study (2006–2020, N = 27,327), we estimated mixed effect growth curve models to examine associations between modifiable factors and total cognitive function. Findings: This diverse sample of Indigenous (1.65%), Black (11.43%), Hispanic (9.85%), and White (77.07%) older adults had a mean age of 61 (SD = 9.66) and was 52% female. Despite being younger on average (M = 59), 3% of Indigenous respondents reported memory-related diagnoses three times the overall sample rate. Linear mixed-effect growth curve analysis revealed that Indigenous and Black older adults had similar cognitive trajectories. A college education was a protective factor for initial cognitive function (b0 = 3.09, 95% CI: 2.91, 3.27) and over time (b = 0.24, 95% CI: 0.15, 0.33) across ethnicity. Formal (b = 0.21, 95% CI: 0.15, 0.27) and informal (b = 0.26, 95% CI: 0.20, 0.32) volunteering were associated with slower rates of cognitive decline relative to non-volunteers, though these effects may partly reflect socioeconomic status. Among Indigenous older adults, higher education, volunteering, and fewer depressive symptoms were linked to better cognitive outcomes. Interpretation: Despite high levels of resource deprivation, Indigenous older adults demonstrate resilience that supports cognitive health. Expanding access to education and volunteering in later life through targeted social policy may enhance cognitive outcomes in Indigenous communities for generations. Funding: This research was supported by the National Institute on Aging (R36AG078781).http://www.sciencedirect.com/science/article/pii/S2667193X25002170Cognitive healthIndigenousHealth equityNative AmericanAmerican IndianAlaska Native |
| spellingShingle | Cliff Whetung Ernest Gonzales Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context The Lancet Regional Health. Americas Cognitive health Indigenous Health equity Native American American Indian Alaska Native |
| title | Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context |
| title_full | Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context |
| title_fullStr | Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context |
| title_full_unstemmed | Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context |
| title_short | Modifiable factors associated with cognitive health trajectories among Indigenous, Hispanic, Black, and White older adults: an exploratory longitudinal panel analysis of the health and retirement study with a focus on Indigenous peoplesResearch in context |
| title_sort | modifiable factors associated with cognitive health trajectories among indigenous hispanic black and white older adults an exploratory longitudinal panel analysis of the health and retirement study with a focus on indigenous peoplesresearch in context |
| topic | Cognitive health Indigenous Health equity Native American American Indian Alaska Native |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X25002170 |
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