Measuring the Interrelationships Between Cognitive Performance, Race/Ethnicity, Discrimination, Health Behaviors, and Physiological Dysregulation: A Path Analysis of the Multi-Ethnic Study of Atherosclerosis

J Aging Health. 2025 Mar;37(3-4_suppl):40S-52S. doi: 10.1177/08982643241309457. Epub 2025 Mar 23.

Abstract

ObjectiveThe objective of this study was to examine the interrelationships between cognitive performance, race/ethnicity, discrimination, health behaviors, and physiological dysregulation.MethodsWe used data from the Multi-Ethnic Study of Atherosclerosis (MESA) (N = 1667). We used path analyses to examine the association between discrimination, physiological dysregulation, health behaviors, and cognitive performance using the Cognitive Ability Screening Instrument (CASI) at Exam 5 (2010-12) and Exam 6 (2016-18). We examined the relationship between discrimination at Exam 1 (2000-02) and physiological dysregulation at Exam 5. We used overall and ethnoracial-stratified path analysis. All models were adjusted for age, sex, site, depression, stress, socioeconomic status, and APOE-e4.ResultsPhysiological dysregulation was associated with worse cognitive performance in the full sample and among the White ethnoracial subgroup. Everyday discrimination was associated with better cognitive performance among Black participants.DiscussionAssociations between discrimination, physiological dysregulation, and cognitive performance vary and should be examined longitudinally.

Keywords: cognition; discrimination; health behaviors; physiological dysregulation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atherosclerosis* / ethnology
  • Atherosclerosis* / psychology
  • Black or African American / statistics & numerical data
  • Cognition* / physiology
  • Ethnicity* / statistics & numerical data
  • Female
  • Health Behavior* / ethnology
  • Humans
  • Male
  • Middle Aged
  • Racial Groups* / statistics & numerical data
  • Racism*
  • United States
  • White / statistics & numerical data