Mixed-effects logistic regression reveals no significant odds of cognitive decline associated with structural racism in older adults, suggesting broader implications for race and ethnicity.
This study examines whether exposure to structural racism (SR) is associated with subjective cognitive decline (SCD) among older adults. Data were from the 2010 Structural Racism-Related State Laws Database and the 2015-2016 Behavioral Risk Factor Surveillance System (n = 184 731). Exposure was an index of 22 state laws related to criminal justice, economics, healthcare, housing, immigration, and political participation. SCD was self-reported. In the full sample, results from the adjusted mixed-effects logistic regression model did not provide strong evidence of a difference in the odds of SCD for a two-unit greater SR value (OR = 1.00; 95% CI: 0.99-1.01). Similarly, results derived from the effect measure modification models, including product terms between SR and race/ethnicity, did not provide strong evidence of a difference in odds of SCD for White (OR = 0.99; 95% CI: 0.97-1.02) and Black (OR = 1.00; 95% CI: 0.97-1.02) respondents for a two-unit greater SR value. Conversely, Hispanic (OR = 0.91; 95% CI: 0.88-0.93) and Multiracial (OR = 0.95; 95% CI: 0.93-0.97) adults had lower odds of SCD for a two-unit greater SR value. Age-related differences in the association between SR and SCD were observed, with younger Native Hawaiian/Other Pacific Islanders (OR = 0.91; 95% CI: 0.88-0.94) and older American Indian/Alaska Natives (OR = 0.92; 95% CI: 0.89-0.94) experiencing lower odds of SCD for a two-unit greater SR value.
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Cohen et al. (2025) studied this question.
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