Perceived Discrimination and Cognitive Function Among Older Adults: An Analysis of the Health and Retirement Study.

Background

Cognitive aging is a major public health concern, and cognitive health disparities disproportionately affect racially and ethnically minoritized communities. Perceived everyday discrimination has been proposed as a contributor to disparities in cognitive function. This study examines associations between perceived everyday discrimination and cognitive function among older U.S. adults and describes patterns across racial and ethnic groups.

Methods

Data from the Health and Retirement Study (2008-2022) included 45,089 observations from 20,020 participants (aged ≥ 50). Cognitive function was assessed via the adapted Telephone Interview for Cognitive Status, yielding global cognition and episodic memory scores. Perceived everyday discrimination was measured using the 6-item Everyday Discrimination Scale. Associations were evaluated using weighted generalized estimating equations, adjusting for sociodemographic characteristics, educational attainment, health indicators, and survey wave. Analyses incorporated the HRS sampling design, survey weights, longitudinal inverse probability weights for attrition and Leave-Behind nonresponse, and repeated observations within participants.

Results

Non-Hispanic (NH) Black participants reported the highest mean perceived discrimination scores (0.75), followed by NH Other (0.74), whereas NH White (0.53) and Hispanic (0.58) participants reported lower scores. In the full sample, higher perceived discrimination was associated with lower global cognition (estimate: -0.43; 95% CI: -0.52, - 0.33) and lower episodic memory (- 0.30; 95% CI: -0.37, - 0.24). In race- and ethnicity-stratified analyses, inverse associations between perceived discrimination and global cognition were observed among Hispanic, NH Black, and NH White participants. Among these groups, estimates ranged from - 0.47 among Hispanic participants (95% CI: -0.66, - 0.28) to - 0.42 among NH White participants (95% CI: -0.53, - 0.31).

Conclusions

Perceived discrimination is associated with lower cognitive performance. Although exposure levels vary across racial and ethnic groups, associations with cognition are broadly consistent in direction, highlighting perceived discrimination as an important social correlate of cognitive health among aging populations.