Geographic Inequalities in Rate of Memory Decline Among Older Adults in the United States

Elizabeth Rose Mayeda , University of California, Los Angeles
Audrey Murchland, University of California, San Francisco
Joan Casey, University of California, Berkeley
Paola Gilsanz, Kaiser Permanente Northern California Division of Research
Rachel Whitmer, University of California, Davis
Maria Glymour, University of California, San Francisco

Stark geographic inequalities in health and life expectancy divide the United States. Memory decline is the hallmark of Alzheimer’s disease, a debilitating late-life health outcome. We evaluated whether rural-Southern childhood residence was associated with late-life memory decline among Health and Retirement Study participants (n=12,806) interviewed biennially from 1998-2016. Rural-Southern childhood residence was based on self-reported rurality (rural or non-rural) of childhood residence and state of childhood residence. Memory was assessed using immediate and delayed word list recall or the Informant Questionnaire for Cognitive Decline. In race-stratified linear mixed effects models (with age in decades as the timescale and linear splines), we estimated the effect of rural-Southern childhood residence on rate of memory decline, accounting for practice effects, sex, birth year, and parental education. On average, participants with rural-Southern childhood residence experienced approximately 9% faster rate of memory decline at ages >70 years for both Black and White participants.

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 Presented in Session 6. Health & Mortality & Aging