背景:老年人认知表现的教育差异有很好的记录。探索这种关联的研究通常估计教育对认知表现的单一平均影响。我们认为,有助于教育与认知表现之间关联的过程不太可能在所有认知表现水平上都具有同等效果。在这项研究中,我们采用了一种分析方法,该方法使我们能够超越平均值,在结果分布中,检验教育与全球和领域特定认知表现的五项指标之间的关联.
方法:这项横断面研究包括来自阿姆斯特丹纵向衰老研究的1,780名58-68岁的老年人。条件分位数回归用于检查结果分布中的变化。认知结果包括迷你精神状态检查(MMSE)评分,结晶的智力,信息处理速度,情景记忆,和全球认知表现的综合得分。
结果:结果显示,教育和不同认知测量之间的关联在不同的结果分布上有所不同。具体来说,我们发现教育与结晶智力有更强的联系,MMSE,以及绩效分布下尾的复合认知绩效度量。在结果分布中,教育和信息处理速度与情景记忆之间的关联是一致的。
结论:在成绩分布的较低尾部,教育和某些认知表现领域之间的较大关联意味着不平等主要是在成绩较低的个体中产生的,而不是在平均和高绩效的个体中产生的。此外,一些结果分布之间不同的关联表明,通过标准回归方法估计单一平均效应可能会忽略教育群体之间认知表现的差异。未来的研究应该考虑结果分布的异质性。
Educational differences in cognitive performance among older adults are well documented. Studies that explore this association typically estimate a single average effect of education on cognitive performance. We argue that the processes that contribute to the association between education and cognitive performance are unlikely to have equal effects at all levels of cognitive performance. In this study, we employ an analytical approach that enables us to go beyond averages to examine the association between education and five measures of global and domain-specific cognitive performance across the outcome distributions.
This cross-sectional study included 1,780 older adults aged 58-68 years from the Longitudinal Aging Study Amsterdam. Conditional quantile regression was used to examine variation across the outcome distribution. Cognitive outcomes included Mini-Mental State Examination (MMSE) score, crystallized intelligence, information processing speed, episodic memory, and a composite score of global cognitive performance.
The results showed that the associations between education and different cognitive measures varied across the outcome distributions. Specifically, we found that education had a stronger association with crystallized intelligence, MMSE, and a composite cognitive performance measure in the lower tail of performance distributions. The associations between education and information processing speed and episodic memory were uniform across the outcome distributions.
Larger associations between education and some domains of cognitive performance in the lower tail of the performance distributions imply that inequalities are primarily generated among individuals with lower performance rather than among average and high performers. Additionally, the varying associations across some of the outcome distributions indicate that estimating a single average effect through standard regression methods may overlook variations in cognitive performance between educational groups. Future studies should consider heterogeneity across the outcome distribution.