Educational attainment and dementia among older women in the US: Variation by immigration status

Higher education is associated with lower dementia risk. However, less is known about the moderating role of immigration status among women. The aims of this study were to: (a) examine the association between educational attainment and dementia among older women and (b) assess the moderating role of immigration status. Data were obtained from the 2020 Health and Retirement Study. Unadjusted and multivariable multinomial logistic regression models adjusting for sociodemographic confounders and depression were used to determine the association between education and cognition status by immigration status. Among U.S.-born and immigrant women, every increase in year of education was associated with a 28% (OR: 0.72; 95% CI: 0.67-0.78) and 22% (OR: 0.78; 95% CI: 0.72-0.85) decrease in the odds of having dementia compared to being cognitively normal, respectively. Among U.S.-born and immigrant women, not having a college degree was associated with two times (OR: 2.26; 95% CI: 1.42-3.62) and five times (OR: 4.70; 95% CI: 1.46-15.1) the odds of having dementia. Among U.S.-born and immigrant women, not completing high school was associated with approximately seven times the odds of having dementia (OR: 6.55; 95% CI: 4.05-10.6; OR: 6.62; 95% CI: 3.84-11.4, respectively). The odds of having dementia were always greater in immigrant women than U.S.-born women. Educational interventions geared toward reducing dementia risk should consider these differences and target other protective factors for immigrant adult women living in the United States.