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Primary Submission Category: Structural factors
Linkages between Educational Context and Biological Risk Factors of Alzheimer’s Disease and Other Related Dementias (ADRD) among Early Midlife Americans
Authors: Taylor Hargrove, Heming Pei, Jessica Polos, Chantel Martin,
Presenting Author: Taylor Hargrove*
Educational attainment strongly predicts later life cognition and mediates Black-White disparities in ADRD, yet little is known about the quality and context of schooling that shape the educational experience. Historical and contemporary processes of structural racism may differentiate the educational contexts of Black and White students, creating unequal educational pathways to ADRD risk. We examine the relationship between adolescent educational contexts and biological risk factors for ADRD among Black and White early midlife adults and assess whether educational attainment mediates this relationship.
Using Waves I (1994-95) and V (2016-18) of the National Longitudinal Study of Adolescent to Adult Health, we developed two indices of adolescent educational context: 1) a contextual disadvantage index (CDI), reflecting differences in resources/opportunities between schools, and 2) a structural racism index (SRI), capturing Black-White inequities across resources/opportunities within schools. Indicators spanned student background characteristics, school characteristics, academic performance, academic selectivity, school connectedness, and perceived life chances. Outcomes (Wave V) included three epigenetic clocks (PhenoAge, GrimAge2, DunedinPACE) and 4 inflammatory markers (C-reactive protein (CRP); IL-6; IL-10; tumor necrosis factor-a). Weighted regression models and causal mediation analyses were used.
Attending schools with more disadvantages (e.g., higher CDI) was associated with faster epigenetic aging and higher IL-6 among Black and White respondents, and higher CRP and TNF-a among White respondents. Attending schools with greater Black-White inequities (e.g., higher SRI) was linked to decelerated epigenetic aging and lower CRP. Significant CDIxSRI interactions indicated faster epigenetic aging among those who attended contextually disadvantaged schools with lower Black-White inequities. Educational attainment explained between 31-60% of these associations.