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• W2897634828 abstract "Stark geographic inequalities in health and life expectancy divide the United States (U.S.), with residents of the rural south experiencing some of the poorest health outcomes. Lifecourse epidemiology suggests childhood place of residence may be particularly relevant for late-life health, but few prior studies have linked geographic place of residence in childhood to late-life cognitive outcomes. We evaluated whether childhood residence in the rural southern U.S. was associated with late-life memory decline among U.S.-born participants of a nationally-representative study of adults age 50 years and older. Health and Retirement Study participants (n=12,806) were interviewed biennially from 1998-2014. Rural southern childhood residence (yes/no) was based on self-reported rurality (rural or non-rural) and state of childhood residence. Composite memory (z-scored) was assessed using immediate and delayed word list recall or the Informant Questionnaire for Cognitive Decline. We used linear mixed effects models (with age in years as the timescale and linear splines with a knot at age 70 to account for nonlinearities) to estimate the effect of rural southern childhood residence (yes/no) on rate of memory decline, accounting for practice effects, adjusting for sex, race, birth year, and parental educational attainment, and applying sampling weights. Mean age in 1998 was 64.5 years (range 50-102); 17.9% of the sample reported rural southern childhood residence. Participants were followed for a mean of 12.7 years. Average annual rate of change in memory after age 70 among unexposed (non-rural and non-southern childhood residence) participants was -0.755 (95% confidence interval: -0.796, -0.714). On average, participants with rural southern childhood residence experienced approximately 10% faster rates of memory decline compared with others (for estimated effect of rural southern childhood residence on annual rate of change after age 70, beta = -0.072; 95% confidence interval: -0.101, -0.043) (Figure 1). Predicted memory trajectories by rural southern childhood residence (yes/no) from adjusted linear mixed effects models. Shown for a non-Latino white woman born in 1930 whose mother and father had <8 years of education. Childhood residence in the rural south may influence late-life memory decline through multiple pathways, including educational experience, labor market opportunities, and cardiometabolic health. Future studies are needed to investigate the lifecourse pathways driving this inequality, the extent to which geographic inequalities contribute to racial inequalities, and potential population-level interventions to promote equity in cognitive aging." @default.
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• W2897634828 date "2018-07-01" @default.
• W2897634828 modified "2023-10-16" @default.
• W2897634828 title "P2‐611: GEOGRAPHIC INEQUALITIES IN RATE OF MEMORY DECLINE AMONG OLDER ADULTS IN THE UNITED STATES" @default.
• W2897634828 doi "https://doi.org/10.1016/j.jalz.2018.06.1307" @default.
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