Study Addresses Why Blacks Are At Higher Risk of Cognitive Impairment in Later Life Interview with:

Zhenmei Zhang, Ph.D. Associate Professor Department of Sociology Michigan State University East Lansing, MI48824

Dr. Zhenmei Zhang

Zhenmei Zhang, Ph.D.
Associate Professor
Department of Sociology
Michigan State University
East Lansing, MI48824 What is the background for this study?

Dr. Zhang: Blacks are especially hard hit by cognitive impairment and dementia. Recent estimates of dementia prevalence and incidence were substantially higher for blacks than whites. Reducing racial/ethnic disparities in dementia has been identified as a national priority by the National Alzheimer’s Project Act, which was signed into law by President Obama in 2011. So I really want to contribute to the ongoing discussion of the origins and pathways through which racial disparities in cognitive impairment is produced. If we have a better understanding of the factors contributing to racial disparities in cognitive impairment in later life, more effective interventions can be conducted to reduce the racial disparities. What are the main findings?

Dr. Zhang: We have three major findings.

  • First, using nationally representative data, we find that blacks aged 65 and older had a higher risk of severe cognitive impairment at the baseline and during the 12-year follow-up from 1998 to 2010.
  • Second, we find that older blacks are more likely to be born in the South and experience childhood adversity, both of which are associated with higher risk of severe cognitive impairment. We conclude that part of the reason that blacks have higher risk of cognitive impairment is their disadvantaged childhood.
  • Third, we find that adulthood socioeconomic conditions, especially education, is significantly associated with the risk of severe cognitive impairment and the wide racial gap in adulthood SES explains a significant part of the racial disparities in cognitive impairment. What should readers take away from your report?

Dr. Zhang: Based on our results, we think that in order to reduce racial disparities in cognitive impairment, more emphasis should be put on reducing racial gaps in socioeconomic resources over the life course. There are multiple windows of opportunities for intervention and the most important ones are in early life and young adulthood. What recommendations do you have for future research as a result of this study?

Dr. Zhang:  Future research should produce screening instruments that take into consideration the quality of education the respondents have received and the different racial/ethnic attitudes toward cognitive impairment.

Future research should also tap into potential racial differences in childhood nutrition and growth, childhood trauma and maltreatment such as abuse, neglect, discrimination, and family stressors such as parental conflicts and parental loss, which may contribute to racial differences in cognitive impairment. Is there anything else you would like to add?

Response: Our study shows that racial disparities in cognitive impairment, though substantially reduced, are not eliminated when controlling for childhood and adulthood socioeconomic factors. More research is needed to find out additional factors that can explain Black’s higher risk of severe cognitive impairment than whites in later life. Thank you for your contribution to the community.


Zhenmei Zhang, Mark D. Hayward, and Yan-Liang Yu. Life Course Pathways to Racial Disparities in Cognitive Impairment among Older Americans. Journal of Health and Social Behavior, May 2016 DOI:10.1177/0022146516645925

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Last Updated on June 3, 2016 by Marie Benz MD FAAD