Jordan J Dworkin’s research while affiliated with New York State Psychiatric Institute and other places

Background Peers influence adolescent behavior, educational, and health outcomes. Evaluating the influence of school‐mates’ cognitive aptitude on later‐life cognition is important for understanding the role of school segregation and tracking in establishing inequality. Yet, few studies have the data to study this. We used a national high‐school based study followed up 58 years later to examine if attending schools with more skilled peers predicts individual later‐life cognition. Method In 1960, about 5% of US high schools participated in Project Talent (n=377,000), where students reported demographics and completed aptitude tests. Some of these students were enrolled in 2018/2019 (mean age=74.6) in the Project Talent Aging Study (PTAS). For each PTAS participant, we calculated peer cognitive aptitude as the average of cognitive aptitudes of all other students who were in the same high school. The outcome, later‐life cognition, was operationalized as z‐score composites for language (semantic and phonemic fluency) and memory (CERAD learning list and delayed recall). For each outcome we estimated multilevel linear models to account for school clustering. All models were adjusted for age, sex/gender, parental education; secondary models were also adjusted for the participant’s own adolescent cognitive aptitude. To examine heterogeneity of the association, we evaluated interactions of peer ability with sex/gender, and the participant’s own adolescent cognitive aptitude. Result Participants were predominantly non‐Hispanic White (80.4%) and women (52.6%). Attending schools with peers who averaged 1 standard deviation higher on cognitive aptitude predicted better later‐life cognition prior to adjustment for own aptitude (language: β=0.162, 95% CI: 0.120, 0.205; memory: β=0.084, 95% CI: 0.041, 0.126), but not after adjustment. However, for women (β=0.045, 95% CI: ‐0.012, 0.101) and those with below mean adolescent cognitive aptitude (β=0.091; 95% CI: 0.016, 0.166), attending schools with higher ability peers predicted better later‐life language scores even after own ability was considered. There was no moderation of these relationships by race/ethnicity. Conclusion People with below average cognitive aptitude in adolescence had better language function 58 years later if they attended high schools with high aptitude peers. Future work will examine the plausible life‐course mechanisms to address why certain groups benefit more from schooling contextual factors.

Background Subjective Cognitive Decline (SCD), a proposed marker of preclinical Alzheimer’s disease (AD), is commonly associated with depressive symptoms. However, the basis and directionality of this association is unclear. Divergent hypotheses propose that mood changes either cause SCD or represent a psychological reaction to perceived cognitive decline. Alternatively, mood and SCD may both be part of a dementia prodrome. Longitudinal evaluation is critical to understand the temporal ordering of SCD and depressive symptoms. Further, given known differences in the prevalence of depressive symptoms across sex‐ethnoracial groups, it is important to examine temporality across these groups. Methods 3365 (68% women, 75 (SD=6) years old, 10 (SD=5) years educated) participants without dementia at baseline were included in this study. Of these, 1005 were non‐Hispanic Black, 1450 Hispanic and 910 non‐Hispanic White. Depressive symptoms were measured using the Center for Epidemiological Studies Depression scale (CES‐D). SCD was assessed with a 9‐item questionnaire assessing memory difficulties. Separate autoregressive generalized additive mixed effects models (GAMMs) were conducted. Each model included a lagged cross‐symptom variable, an autoregressive same‐symptom variable, and a within‐visit association between CES‐D and SCD. Models additionally included age, time in study, dementia status, education and objective memory performance. Primary coefficients of interest were lagged cross‐symptom effects, estimated across and within sex‐ethnoracial groups. Results Whole‐sample results showed similar coefficients for models of SCD predicting depressive symptoms (b=.021, p=.021) and models of depressive symptoms predicting SCD (b=.045, p=.001; Figure 1). Stratified analyses showed that within Black participants, depressive symptoms preceded SCD (b=.098, p<.001) whilst the opposite pattern was seen in Hispanic participants (b=.025, p=.027). With regard to sex, depressive symptoms preceded SCD in men, particularly white men (b=.141, p=.004). In contrast, SCD preceded depressive symptoms in women, primarily Hispanic women (b=.030, p=.019). Conclusions Results provide evidence for bidirectionality between depressive symptoms and SCD, underscoring the multiple pathways by which these two factors are linked in the course of cognitive aging. However, stratified results reveal nuanced patterns between depressive symptoms and SCD across sex‐ethnoracial groups that may offer clues to the relevance of SCD as a marker of pre‐clinical AD in different populations.