NewsWire: 9/23/2020
- According to a new study, Boomers are scoring lower on cognitive function tests than previous generations of Americans at the same age. Beginning with the Lost Generation, average age-adjusted cognition scores rose steadily across successive birth cohorts, but these results suggest the positive trend may be reversing. (The Journals of Gerontology: Series B)
- NH: This is a good news-bad news story. But I have to warn you, it's mostly bad news.
- The good news, which has already been widely reported by researchers, is that rates of dementia and cognitive impairment among older Americans have been broadly declining over the last several decades. (See "The Curious Case of Declining Dementia.") Among the elderly, the absolute number with dementia is going up, but the rate of dementia at any given age is going down.
- OK, you may be saying, that's good news: So what's the catch? The catch is this. Since rates of dementia go up steeply by age, the overall rate of dementia is mostly determined by what's happening among people over 75 and especially over 85. Thus, the reported good news has been driven mainly by the aging of the G.I. and Silent Generations--born from around 1900 to 1945. Yes, each of these birth cohorts appear to be in progressively better cognitive health than the cohorts born just before them.
- But what about the successive Boomer cohorts coming after them? They are not (quite) yet in the older age brackets in which dementia ramps up. So they aren't yet steering the population-wide number. But what if we were to isolate the younger age brackets (55 to 70) that Boomers have recently occupied and look at how dementia and cognitive health in those age brackets have been trending over time? That would give us an early look at whether Boomers are doing better or worse than the G.I.s and Silent at the same age.
- That's essentially what Hui Zheng at Ohio State University did. He examined a nationally representative database of over 30,000 Americans age 55 to 69 from 1998 to 2014. Each subject was extensively interviewed and then, every few years, given a standard cognitive function test. (Typical exercises were recalling words they had heard earlier, counting down from 100 by 7s, and so on.) The test scores were then tracked over time and normalized for age.
- Zheng's results are sobering. He confirms that successive birth cohorts up to about 1941 did indeed score progressively better at every age. But he also also finds that successive birth cohorts born from 1948 to 1959 scored progressively worse at every age. Remarkably, this decline was significant among Boomers in every demographic: both sexes, all major races/ethnicities, and all educational, vocational, income, and wealth categories. Note, in the following chart, that "early baby boomers" are defined as born from 1948 to 1953 and "mid baby boomers" are born from 1954 to 1959.
- Using extensive regression analysis, Zheng then tried to figure out what has been driving this Boomer decline. When he looked at early childhood and developmental factors typically associated with later dementia, he found that these Boomers actually should have scored better, not worse. Relative to earlier cohorts, they had better childhood nutrition (as measured by adult height), had more affluent parents, had more years of education, and were more likely to have white-collar jobs. (One negative: They reported more abuse by their parents.)
- With all these positives, there must have been powerful negatives working the other way. What were they? Most importantly, "Baby Boomers... are generally disadvantaged in the psychosocial domain," explains Zheng. They are more likely to have multiple marriages and less likely to be currently married. A larger share have no children and no religious affiliation. They report substantially higher levels of loneliness and depression. They also have less net worth and are less likely to be located in higher wealth quintiles. All of these factors, Zheng reports, are positive correlated with cognitive impairment.
- Partly tied to this "psychosocial domain" is a rising prevalence of chronic health issues that are also linked to dementia. On the good side, they smoke less than earlier cohorts--which explains why they report less lung disease. But most of the news is on the bad side of the ledger. They are less physically active. They are more obese. And thus they are more likely to report such chronic diseases as hypertension, diabetes, and stroke--along with treatment for psychiatric problems. Zheng suspects that higher rates of substance abuse could also be at work here, but he lacked the data to confirm this.
- While other researchers have recently concluded that cognitive health is no longer improving in younger age brackets, Zheng is among the first to conclude that it is unambiguously worsening.
- Zheng's findings agrees with other broader research on cohort-related changes in Americans' health. As with dementia, most indicators of wellness among the elderly have been improving over the last several decades as cohorts born in the 1890s have been replaced by later-born cohorts through the early 1940s. Yet also, as with dementia, that's where the progress seems to stop and reverse.
- From first- to last-wave Boomers, the trend is toward higher rates of disability and chronic diseases--especially, as Zheng found, those related to obesity, diabetes, and cardiovascular issues. (See "Boomer Malaise.") Over time, holding age constant, we also see across these cohorts rising rates of depression, loneliness, suicide, homelessness, crime, alcoholism, and substance abuse generally. (See "America's Suicide Rate--Up One-Third Since 1999," "Binge Drinking Surges Among Older Adults," and "All the Lonely People.") Some of these trends may be linked to the steep decline in upward economic mobility among late-wave Boomers versus first-wave Boomers. (See "What is Gen Jones?")
- According to Anne Case and Nobel Prize winner Angus Deaton, all of the above help to explain the growing "deaths of despair" among middle-aged Americans. And indeed, these deteriorating health indicators among late-wave Boomers (along with Xers) account for more than all of the recent decline in U.S. life expectancy. (See "Death Becomes Us... Mortality Increases" and "U.S. Life Expectancy Rises at Last.")
- We all know that over the next twenty years the absolute number of late-elders with dementia will surge along with the aging of all these Aquarians. Between 2020 and 2040, Americans 85+ are expected to more than double--from 6.7 to 14.4 million. But did we ever expect that the rate at which they would suffer dementia would be rising as well? Chalk this up as one more challenge for today's youth.
- What a long strange trip it's been. Back when older generations were raising Boomer kids during the Eisenhower and Sputnik years, they had "Great Expectations" for them (to borrow from the title of Landon Jones' classic book). They expected these Boomers would become stronger, smarter, healthier, happier, and more affluent by far than any generation before them, model citizens to run the "Great Society" that older generations were about to build for them.
- Clearly, it didn't quite work out that way. And that's not so much due to anything others have done to Boomers. It's more due to what Boomers have done, both individually and collectively, to themselves.
