Evaluating segregated school attendance as a mediator of geographic inequities in late‐life cognitive function: evidence from the Study of Healthy Aging in African Americans (STAR)

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Publicado en:Alzheimer's & Dementia vol. 22, no. 1 (Jan 1, 2026)
Autor principal: Gutierrez, Sirena
Otros Autores: Whitmer, Rachel A., George, Kristen M., Peterson, Rachel L., Thomas, Marilyn D., Lor, Yi, Allen, Isabel E., Barnes, Lisa L., Glymour, M. Maria, Torres, Jacqueline M., Gilsanz, Paola
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John Wiley & Sons, Inc.
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Acceso en línea:Citation/Abstract
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024 7 |a 10.1002/alz.71036  |2 doi 
035 |a 3288564277 
045 0 |b d20260101 
100 1 |a Gutierrez, Sirena  |u Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA 
245 1 |a Evaluating segregated school attendance as a mediator of geographic inequities in late‐life cognitive function: evidence from the Study of Healthy Aging in African Americans (STAR) 
260 |b John Wiley & Sons, Inc.  |c Jan 1, 2026 
513 |a Journal Article 
520 3 |a INTRODUCTION Birth in the Southern United States is associated with poorer late‐life cognitive health, especially among Black Americans, yet the role of school segregation is unclear. METHODS Utilizing decomposition methods, we estimated the total effect, natural direct effect (NDE), and natural indirect effect (NIE) of Southern birth on domain‐specific cognition among 727 older Black adults, adjusting for early‐life covariates. We also estimated the proportion of the total effect mediated by self‐reported segregated school attendance. RESULTS Southern birth was associated with lower late‐life executive function and semantic memory; estimates were negative but not significant for verbal episodic memory. The direct effect of Southern birth was negative but not significant for all domains. Attending a segregated school mediated 35% and 49% of the total association between Southern birth and executive function (NIE: −0.07, 95% confidence interval [CI]: [−0.18, 0.02]) and semantic memory (NIE:−0.17, 95% CI: [−0.29, −0.06]). DISCUSSION School segregation may partially drive geographic inequities in late‐life cognition in the United States. Highlights Southern birth has been linked to poorer cognitive health in later life. Segregated schooling may partially explain geographic disparities in brain aging. Black adults born in the South had lower cognitive function and were more likely to attend segregated schools. Segregated schooling accounted for 35% to 49% of the association between Southern birth and cognition. 
651 4 |a United States--US 
653 |a Cognitive functioning 
653 |a Health disparities 
653 |a Episodic memory 
653 |a Aging 
653 |a Semantic memory 
653 |a Segregation 
653 |a Function 
653 |a School attendance 
653 |a Schools 
653 |a Brain 
653 |a Cognition 
653 |a Verbal memory 
653 |a Geography 
653 |a African Americans 
653 |a Racial differences 
653 |a Cognition & reasoning 
653 |a Life 
653 |a Inequality 
653 |a Executive function 
653 |a Black people 
653 |a Adults 
653 |a Brain health 
653 |a Memory 
700 1 |a Whitmer, Rachel A.  |u Alzheimer's Disease Center, University of California, Davis, Sacramento, California, USA 
700 1 |a George, Kristen M.  |u Department of Public Health Sciences, University of California Davis, Davis, California, USA 
700 1 |a Peterson, Rachel L.  |u School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA 
700 1 |a Thomas, Marilyn D.  |u Department of Medicine, University of California San Francisco, San Francisco, California, USA 
700 1 |a Lor, Yi  |u Department of Public Health Sciences, University of California Davis, Davis, California, USA 
700 1 |a Allen, Isabel E.  |u Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA 
700 1 |a Barnes, Lisa L.  |u Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA 
700 1 |a Glymour, M. Maria  |u Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA 
700 1 |a Torres, Jacqueline M.  |u Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA 
700 1 |a Gilsanz, Paola  |u Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA 
773 0 |t Alzheimer's & Dementia  |g vol. 22, no. 1 (Jan 1, 2026) 
786 0 |d ProQuest  |t Consumer Health Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3288564277/abstract/embedded/2AXJIZYYTBW5RQEH?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3288564277/fulltext/embedded/2AXJIZYYTBW5RQEH?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3288564277/fulltextPDF/embedded/2AXJIZYYTBW5RQEH?source=fedsrch