Educational attainment, secondary school features, and midlife cognitive functioning: understanding the associations between education and cognitive domains.

OBJECTIVES

This study aimed to examine the associations between educational characteristics and cognitive functioning among U.S. early midlife adults and to assess how biological sex modifies these associations.

METHODS

Using data on up to 9,420 participants from Waves I-VI of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we assessed the association between education (degree attained and secondary school features) and cognitive functioning (working memory, episodic memory, executive function, processing speed, and language/fluency) at midlife (ages 39 to 51 years) with linear regression. We adjusted for sociodemographic characteristics, measures of adolescent cognition (baseline Add Health Picture Vocabulary Test), and social origins to minimize confounding of the exposure-outcome relationship. We further examined the interaction between degree attained and secondary school features and these associations stratified by biological sex. Weights for the complex Add Health sampling design were applied to ensure nationally representative results.

RESULTS

Higher educational attainment was consistently associated with better midlife cognition, as measured by the composite TestMyBrain cognition score. Associations generally followed dose-response patterns by degree attained. In contrast, school feature measures were largely not associated with midlife cognition, and effect sizes were inconsistent when present. Sex-stratified analyses revealed similar patterns across sexes, though associations between education and some working memory and language measures were stronger among men, while associations with some episodic memory measures were stronger among women.

DISCUSSION: Educational attainment is strongly associated with cognitive functioning in midlife, after adjustment for adolescent cognitive performance and social origins.