Terminal decline of episodic memory and perceptual speed in a biracial population

Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2018 May;25(3):378-389. doi: 10.1080/13825585.2017.1306020. Epub 2017 Mar 23.


We compared trajectories of terminal cognitive decline in older Black (n = 3372) and White (n = 1756) persons from a defined population who completed tests of episodic memory and perceptual speed at 3-year intervals for up to 18 years. During a mean of 9.9 years of observation, 1608 Black persons and 902 White persons died. Preterminal decline of episodic memory did not differ by race. Terminal episodic memory decline began earlier in Black persons (mean of 4.3 years before death) than in White persons (mean = 3.9 years) and progressed more slowly. By contrast, terminal decline of perceptual speed began earlier in White persons (mean = 5.0 years) than in Black persons (mean = 4.5 years). Rate of perceptual speed decline was more rapid in White persons than in Black persons in both the preterminal and terminal periods. The results indicate that terminal cognitive decline occurs in Black persons but suggest that the rate of cognitive decline during the terminal period is less rapid in Black persons than in White persons.

Keywords: Terminal decline; episodic memory; longitudinal study; perceptual speed; racial differences.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Black or African American
  • Chicago
  • Cognitive Aging
  • Cognitive Dysfunction / ethnology*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Memory, Episodic*
  • Time Factors
  • White People