Does a Lifetime of Discrimination Affect Cognitive Function?

The Life After 90 study aimed, in part, to determine the impact of major lifetime discrimination on cognitive function and dementia in patients over 90 years old. The study results were presented at the recent 2022 Alzheimer’s Association International Conference.

In this interview, Kristen George, MPH, PhD, a postdoctoral scholar in the Department of Public Health Sciences at the University of California Davis, discusses the findings.

Following is a transcript of her remarks:

What I was interested in was whether experiences of discrimination were associated with cognitive change over time in this oldest-old group. Because they’re so old, a lot of them have experienced like Jim Crow laws and segregation. They have a wealth of experience. And so if we can really see that in this group, they’re survivors. They’re obviously all over age 90, so to some extent they are good agers.

And we found that when we asked participants about their experiences of discrimination and then grouped them based on their experiences, we found three groups. One group was mostly white men who reported job discrimination. Then we had a second group that was mostly white women and participants of other races and ethnicities who reported no discrimination, or very little discrimination. And then a third group that was all non-white participants who reported pretty widespread discrimination across the different measures.

And so we would think that the second class that reported little to no discrimination would have the highest cognition and maybe not be declining as quickly. But we actually found that the first class, class one with mostly white men, they had the highest cognition in two domains at baseline, followed by class two with no discrimination. And then class three had the lowest cognition at baseline for two domains. And we didn’t see any differences in trajectory over time. They were all kind of declining at about the same rate.

I think it’s really important first work, because we don’t really know that much about this group. I mean, just their cognition in general, but definitely not about how they’ve experienced racism.

And so I think the next step is to really kind of dig into how we would like to measure racism, and go beyond just discrimination. Because that kind of measures interpersonal racism, but it doesn’t really discriminate between people who are experiencing unfair treatment and systematic disadvantage, which we might be able to better measure using measures of structural racism and better understanding the de facto and du jour policies that actually impacted and shaped these participants’ lives. So I think a lot more work into how we measure racism is really the next step.

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