Educational Attainment and Cognitive Change: A Life-Course Mediation Analysis of Lifestyle, Environment, and Health

Andrea Dalecka , Masaryk University
Eliska Hrezova, Masaryk University
Anna Bartoskova Polcrova, Masaryk University
Nadezda Capkova, National Institute of Public Health
Pavel Piler, Masaryk University
Hynek Pikhart, University College London
Martin Bobak, University College London

Introduction: Education plays a crucial role in cognitive performance across the life course, partly through its influence on lifestyle behaviours, social engagement and environmental and living conditions that jointly contribute to cognitive aging. Understanding these pathways is essential for identifying targets to support healthy cognitive functioning in later life. Methods: We used data from the Czech arm of the HAPIEE study. We estimated a latent change score model (LCSM) to examine change in cognitive functioning measured at two time points over 20 years of follow-up. We specified a three-wave multiple mediation model adjusted for sex and age to examine longitudinal pathways linking educational attainment to late-life cognitive change. Time-invariant lifestyle factors, environmental exposures, self-rated health, and depression were considered as potential mediators, while marital status and loneliness as late-life predictors. Results: Study sample included 8,810 participants (53.5% women) aged 58.19 years at baseline. Higher level of education was associated with increased cognitive performance at Wave 1 (ß = 0.349; p<.001), but not with cognitive change (ß = -0.030; p=.367). Indirect pathways linking education attainment and cognitive change were identified. Specifically, individuals with higher education reported higher levels of physical activity, which in turn predicted a better self-rated health, serving as a protective factor of cognitive decline (indirect effect of education mediated by physical activity and self-rated health: ß = 0.001; p=.050). Conclusion: Our findings underscore the need for supportive policies and practices that maximizes the benefits of education and midlife healthy behaviour to sustain cognitive abilities in later life.

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 Presented in Session 60. Climate Change, Environment and Health