Social
Differential associations between early-life education and dementia risk by childhood socioeconomic status, race, and sex Whitney Wells* Whitney Wells Jilly Hebert Anusha Vable
Early-life education plays a key role in child development, which influences later cognitive health. However, access to early education varies widely in the US. Two common pre-K educational options are paid preschool and Head Start (free preschool for families with low income). To inform policy related to pre-K access, this study evaluates if attendance at preschool or Head Start is associated with dementia risk.
We used the National Longitudinal Survey of Youth 1979 (NLSY) to examine the relationship between self-reported attendance at preschool or Head Start and dementia risk. We used results from a prediction model that extends on a previously validated algorithm estimating dementia risk from cognition measures (mid-life memory, attention, and mental status) and mid-life demographics and health conditions. We adjusted for demographic factors and proxies for childhood SES (cSES), and examined subgroup differences by race/sex and father’s employment status as a marker of cSES with interaction terms.
There was little relationship between preschool and dementia risk in all models, or for Head Start and dementia risk overall; however, in stratified models, we found differential relationships for Head Start by father’s employment status and race/sex. While individuals whose fathers were employed showed no association, attending Head Start was associated with lower dementia risk for individuals whose fathers were not present in the household (-0.01; 95% CI: -0.02, -0.001). Head Start was associated with higher dementia risk for White men (0.02; 0.003, 0.03) but lower dementia risk for Black men (-0.01; -0.02, -0.001), with limited evidence for an association for Hispanic men and women, White women, or Black women.
The Head Start program may have reduced socioeconomic and Black-White dementia inequities by lowering dementia risk for individuals who grew up in single-mother households and for Black men.
