B - 64 Exploring the Role of Education in Predicting Older Veterans’ Functional Performance on the Pillbox Test

Abstract Objective Previous research demonstrates older adults with less education are at higher risk of medication nonadherence (Jin et al. 2016). The Pillbox Test is a process-oriented, performance-based measurement of executive functioning designed and validated by Zartman and colleagues (2013) which may help identify individuals at risk of medication nonadherence and functional impairment. This study aimed to assess the impact educational attainment has on Pillbox Test performance. Method Participants (n = 208) included a mixed diagnostic sample of older adults who completed the Pillbox Test as part of a comprehensive neuropsychological evaluation within a neuropsychology clinic between 2019–2024 (Mage = 71.54, Meducation = 13, 62.5% Caucasian, 89.9% male). Correlational and regression analyses were conducted to evaluate the relationship between education and Pillbox Test performance. Results Pearson correlations revealed a significant negative correlation between years of education and Pillbox Test total errors, r(206) = −0.14, p < 0.05, such that lower education was associated with greater errors. However, linear multiple regression analyses revealed education did not uniquely predict errors on the Pillbox Test when accounting for demographic variables (race, education, age, gender). Race was the only significant predictor of Pillbox errors. Specifically, identification as Hispanic (β = 0.21, p < 0.01) or African American (β = 0.18, p < 0.05) predicted greater errors. Conclusion(s) While lower education is associated with poorer Pillbox Test performance, it does not uniquely predict performance when accounting for other demographic variables. That said, the Pillbox Test appears to be a robust measure of functional ability and executive functioning among older adults with diverse educational backgrounds and may be less susceptible to the influence of formal education than other similar measures.