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Its association with brain health in midlife has not been thoroughly investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied, cross\u2010sectionally, 616 middle\u2010aged adults (mean age of 55.1\u00a0\u00b1\u00a03.6 years, 53% female and 38% Black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study. We correlated literacy with cognitive tests, gray matter volumes, and fractional anisotropy (FA) values (indirect measures of white matter integrity) using linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The higher\u2010literacy group (<jats:italic>n<\/jats:italic>\u00a0=\u00a0499) performed better than the low\u2010literacy group (<jats:italic>n<\/jats:italic>\u00a0=\u00a0117) on all cognitive tests. There was no association between literacy and gray matter volumes. The higher\u2010literacy group had greater total\u2010brain FA and higher temporal, parietal, and occipital FA values after multivariable adjustments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Higher literacy is associated with higher white matter integrity as well as with better cognitive performance in middle\u2010aged adults. These results highlight the importance of focusing on midlife interventions to improve literacy skills.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dad2.12363","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T07:05:03Z","timestamp":1670569503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Higher literacy is associated with better white matter integrity and cognition in middle age"],"prefix":"10.1002","volume":"14","author":[{"given":"Elisa de Paula Fran\u00e7a","family":"de Resende","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais  Belo Horizonte Brazil"},{"name":"Global Brain Health Institute  San Francisco and Dublin USA and Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Xia","sequence":"additional","affiliation":[{"name":"Northern California Institute for Research  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Sidney","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Division of Research  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenore J.","family":"Launer","sequence":"additional","affiliation":[{"name":"National Institute on Aging  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J.","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guray","family":"Erus","sequence":"additional","affiliation":[{"name":"Department of Radiology Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania 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