{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:03:55Z","timestamp":1791356635717,"version":"4.3.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Wave VI of Add Health","award":["U01 AG071448"],"award-info":[{"award-number":["U01 AG071448"]}]},{"name":"Wave VI of Add Health","award":["U01 AG071450"],"award-info":[{"award-number":["U01 AG071450"]}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006085","name":"Office of Disease Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006085","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Office of Behavioral and Social Science Research"},{"name":"Waves I\u2013V of Add Health","award":["P01 HD31921"],"award-info":[{"award-number":["P01 HD31921"]}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","award":["U01 AG071448"],"award-info":[{"award-number":["U01 AG071448"]}],"id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","award":["U01 AG071450"],"award-info":[{"award-number":["U01 AG071450"]}],"id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","award":["P01 HD31921"],"award-info":[{"award-number":["P01 HD31921"]}],"id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data on up to 9,420 participants from Waves I\u2013VI 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\u00a0years) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Educational attainment is strongly associated with cognitive functioning in midlife, after adjustment for adolescent cognitive performance and social origins.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geronb\/gbag159","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:13:50Z","timestamp":1786101230000},"page":"S193-S203","source":"Crossref","is-referenced-by-count":2,"title":["Educational attainment, secondary school features, and midlife cognitive functioning: understanding the associations between education and cognitive domains"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3663-1360","authenticated-orcid":false,"given":"Rebecca C","family":"Stebbins","sequence":"first","affiliation":[{"name":"Robert N. Butler Columbia Aging Center, Columbia University Irving Medical Center, Columbia University , New York, New York,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Hummer","sequence":"additional","affiliation":[{"name":"Carolina Population Center, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]},{"name":"Department of Sociology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farizah I","family":"Rob","sequence":"additional","affiliation":[{"name":"Robert N. Butler Columbia Aging Center, Columbia University Irving Medical Center, Columbia University , New York, New York,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1907-0810","authenticated-orcid":false,"given":"Chantel L","family":"Martin","sequence":"additional","affiliation":[{"name":"Carolina Population Center, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]},{"name":"Department of Epidemiology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0036-626X","authenticated-orcid":false,"given":"Lauren","family":"Gaydosh","sequence":"additional","affiliation":[{"name":"Carolina Population Center, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]},{"name":"Department of Sociology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7132-1843","authenticated-orcid":false,"given":"Yang Claire","family":"Yang","sequence":"additional","affiliation":[{"name":"Carolina Population Center, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]},{"name":"Department of Sociology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison E","family":"Aiello","sequence":"additional","affiliation":[{"name":"Robert N. Butler Columbia Aging Center, Columbia University Irving Medical Center, Columbia University , New York, New York,","place":["United States"]},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University , New York, New York,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026100614335482500_gbag159-B1","doi-asserted-by":"publisher","DOI":"10.10183\/geronb\/gbag161","article-title":"Study design and results of the Wave VI Add Health Cognitive Assessment, Physical, and Sensory Function (Add CAPS) Protocol","volume":"81","author":"Aiello","year":"2026","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"key":"2026100614335482500_gbag159-B2","doi-asserted-by":"publisher","first-page":"100232","DOI":"10.1016\/j.jeoa.2019.100232","article-title":"The gender gap in education and late-life cognition: Evidence from multiple countries and birth cohorts","volume":"16","author":"Angrisani","year":"2020","journal-title":"Journal of the Economics of Ageing"},{"key":"2026100614335482500_gbag159-B3","doi-asserted-by":"publisher","first-page":"613","DOI":"10.3102\/0162373718787917","article-title":"The impact of school SES on student achievement: Evidence from US statewide achievement data","volume":"40","author":"Armor","year":"2018","journal-title":"Educational Evaluation and Policy Analysis"},{"key":"2026100614335482500_gbag159-B4","doi-asserted-by":"publisher","DOI":"10.17615\/1kf8-6h07","volume-title":"Constructed SES Variables","author":"Belsky","year":"2020"},{"key":"2026100614335482500_gbag159-B5","doi-asserted-by":"publisher","first-page":"P163","DOI":"10.1093\/geronb\/57.2.P163","article-title":"Education, wealth, and cognitive function in later life","volume":"57","author":"Cagney","year":"2002","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"key":"2026100614335482500_gbag159-B6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/EDE.0b013e31818ef366","article-title":"The consistency statement in causal inference: A definition or an assumption?","volume":"20","author":"Cole","year":"2009","journal-title":"Epidemiology"},{"key":"2026100614335482500_gbag159-B7","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1093\/gerona\/gls122","article-title":"Indicators of childhood quality of education in relation to cognitive function in older adulthood","volume":"68","author":"Crowe","year":"2013","journal-title":"The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences"},{"key":"2026100614335482500_gbag159-B8","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1111\/j.1467-9957.2010.02208.x","article-title":"The Effects of Class Size on the Achievement of College Students","volume":"79","author":"De Paola","year":"2011","journal-title":"The Manchester School"},{"key":"2026100614335482500_gbag159-B9","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1093\/ije\/dyq072","article-title":"Intelligence and education: Causal perceptions drive analytic processes and therefore conclusions","volume":"39","author":"Deary","year":"2010","journal-title":"International Journal of Epidemiology"},{"key":"2026100614335482500_gbag159-B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.socscimed.2016.04.009","article-title":"Long-term health implications of school quality","volume":"158","author":"Dudovitz","year":"2016","journal-title":"Social Science & Medicine"},{"key":"2026100614335482500_gbag159-B11","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.econedurev.2010.11.001","article-title":"School quality, child wellbeing and parents\u2019 satisfaction","volume":"30","author":"Gibbons","year":"2011","journal-title":"Economics of Education Review"},{"key":"2026100614335482500_gbag159-B12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/00001648-199901000-00008","article-title":"Causal diagrams for epidemiologic research","volume":"10","author":"Greenland","year":"1999","journal-title":"Epidemiology"},{"key":"2026100614335482500_gbag159-B13","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/S1054-139X(99)00061-0","article-title":"Smart teens don\u2019t have sex (or kiss much either)","volume":"26","author":"Halpern","year":"2000","journal-title":"The Journal of Adolescent Health"},{"key":"2026100614335482500_gbag159-B14","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1093\/ije\/dyz115","article-title":"Cohort profile: The National Longitudinal Study of Adolescent to Adult Health (Add Health)","volume":"48","author":"Harris","year":"2019","journal-title":"International Journal of Epidemiology"},{"key":"2026100614335482500_gbag159-B15","doi-asserted-by":"publisher","first-page":"101419","DOI":"10.1016\/j.intell.2019.101419","article-title":"The influence of educational attainment on intelligence","volume":"78","author":"Hegelund","year":"2020","journal-title":"Intelligence"},{"key":"2026100614335482500_gbag159-B16","doi-asserted-by":"publisher","first-page":"801","DOI":"10.3758\/BF03211324","article-title":"Gender differences in episodic memory","volume":"25","author":"Herlitz","year":"1997","journal-title":"Memory & Cognition"},{"key":"2026100614335482500_gbag159-B17","doi-asserted-by":"publisher","DOI":"10.17615\/ydjb-4305","volume-title":"Wave VI sampling and mixed-mode survey design","author":"Hummer","year":"2025"},{"key":"2026100614335482500_gbag159-B18","first-page":"1","article-title":"The effect of educational attainment on adult mortality in the United States","volume":"68","author":"Hummer","year":"2013","journal-title":"Population Bulletin"},{"key":"2026100614335482500_gbag159-B19","doi-asserted-by":"publisher","DOI":"10.1083\/geronb\/gbag160","article-title":"Add Health becomes an aging study: Conceptualization, history, and Wave VI design, response, and descriptive health data","volume":"81","author":"Hummer","year":"2026","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"key":"2026100614335482500_gbag159-B20","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1037\/0000187-008","volume-title":"Confronting inequality: How policies and practices shape children\u2019s opportunities","author":"Jackson","year":"2020"},{"key":"2026100614335482500_gbag159-B21","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1111\/j.1532-5415.2011.03499.x","article-title":"A life course model of cognitive activities, socioeconomic status, education, reading ability, and cognition","volume":"59","author":"Jefferson","year":"2011","journal-title":"Journal of the American Geriatrics Society"},{"key":"2026100614335482500_gbag159-B22","doi-asserted-by":"publisher","first-page":"7547","DOI":"10.1002\/alz.14217","article-title":"Gender differences in the association between education and late-life cognitive function in the LifeAfter90 study: A multiethnic cohort of the oldest-old","volume":"20","author":"Lam","year":"2024","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"2026100614335482500_gbag159-B23","doi-asserted-by":"publisher","DOI":"10.17615\/8s2m-yk29","volume-title":"Wave VI user guide to using cross-sectional and longitudinal weights","author":"Liao","year":"2025"},{"key":"2026100614335482500_gbag159-B24","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/1529100620920576","article-title":"Education and cognitive functioning across the life span","volume":"21","author":"L\u00f6vd\u00e9n","year":"2020","journal-title":"Psychological Science in the Public Interest"},{"key":"2026100614335482500_gbag159-B25","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-025-09689-z","article-title":"A systematic review of the measurement and influence of quality of education on neuropsychological test performance in later life","author":"Metcalfe","year":"2026","journal-title":"Neuropsychology Review"},{"key":"2026100614335482500_gbag159-B26","first-page":"14","article-title":"Sex and gender differences in Alzheimer\u2019s disease dementia","volume":"35","author":"Mielke","year":"2018","journal-title":"The Psychiatric Times"},{"key":"2026100614335482500_gbag159-B27","doi-asserted-by":"publisher","first-page":"e70015","DOI":"10.1002\/alz.70015","article-title":"Education and midlife cognitive functioning: Evidence from the high school and beyond cohort","volume":"21","author":"Muller","year":"2025","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"2026100614335482500_gbag159-B28","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/j.jalz.2018.04.008","article-title":"Understanding the impact of sex and gender in Alzheimer\u2019s disease: A call to action","volume":"14","author":"Nebel","year":"2018","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"2026100614335482500_gbag159-B29","doi-asserted-by":"publisher","first-page":"101084","DOI":"10.1016\/j.ssmph.2022.101084","article-title":"Trajectories of cognitive functioning in later life: Disparities by race\/ethnicity, educational attainment, sex, and multimorbidity combinations","volume":"18","author":"Qui\u00f1ones","year":"2022","journal-title":"SSM - Population Health"},{"key":"2026100614335482500_gbag159-B30","volume-title":"R: A language and environment for statistical computing [computer software]","author":"R Core Team","year":"2025"},{"key":"2026100614335482500_gbag159-B31","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s40471-016-0069-5","article-title":"The consistency assumption for causal inference in social epidemiology: When a rose is not a rose","volume":"3","author":"Rehkopf","year":"2016","journal-title":"Current Epidemiology Reports"},{"key":"2026100614335482500_gbag159-B32","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s10654-011-9553-x","article-title":"Higher education delays and shortens cognitive impairment. A multistate life table analysis of the US Health and Retirement Study","volume":"26","author":"Reuser","year":"2011","journal-title":"European Journal of Epidemiology"},{"key":"2026100614335482500_gbag159-B33","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1177\/0956797618774253","article-title":"How much does education improve intelligence? A meta-analysis","volume":"29","author":"Ritchie","year":"2018","journal-title":"Psychological Science"},{"key":"2026100614335482500_gbag159-B34","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1016\/j.jagp.2024.12.002","article-title":"Sex differences in late-life cognition: A psychometric network analysis of well-functioning older adults","volume":"33","author":"Rotstein","year":"2025","journal-title":"The American Journal of Geriatric Psychiatry"},{"key":"2026100614335482500_gbag159-B35","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1037\/neu0000239","article-title":"Cognitive performance in young adulthood and midlife: Relations with age, sex, and education: The cardiovascular risk in Young Finns study","volume":"30","author":"Rovio","year":"2016","journal-title":"Neuropsychology"},{"key":"2026100614335482500_gbag159-B36","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/S0022-4405(02)00124-3","article-title":"School effectiveness findings 1979\u20132002","volume":"40","author":"Rutter","year":"2002","journal-title":"Journal of School Psychology"},{"key":"2026100614335482500_gbag159-B37","doi-asserted-by":"publisher","first-page":"e12424","DOI":"10.1002\/dad2.12424","article-title":"High school quality is associated with cognition 58 years later","volume":"15","author":"Seblova","year":"2023","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"2026100614335482500_gbag159-B38","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1017\/S1355617719000821","article-title":"Examining gender differences in neurocognitive functioning across adulthood","volume":"25","author":"Siedlecki","year":"2019","journal-title":"Journal of the International Neuropsychological Society"},{"key":"2026100614335482500_gbag159-B39","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1017\/S1355617702813248","article-title":"What is cognitive reserve? Theory and research application of the reserve concept","volume":"8","author":"Stern","year":"2002","journal-title":"Journal of the International Neuropsychological Society"},{"key":"2026100614335482500_gbag159-B40","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1093\/aje\/kwz276","article-title":"Early educational experiences and trajectories of cognitive functioning among US adults in midlife and later","volume":"189","author":"Walsemann","year":"2020","journal-title":"American Journal of Epidemiology"}],"container-title":["The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/psychsocgerontology\/article-pdf\/81\/Supplement_2\/S193\/71628899\/gbag159.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/psychsocgerontology\/article-pdf\/81\/Supplement_2\/S193\/71628899\/gbag159.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:34:08Z","timestamp":1791311648000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/psychsocgerontology\/article\/81\/Supplement_2\/S193\/8869177"}},"subtitle":[],"editor":[{"given":"Robert","family":"Crosnoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":40,"journal-issue":{"issue":"Supplement_2","published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/geronb\/gbag159","relation":{},"ISSN":["1079-5014","1758-5368"],"issn-type":[{"value":"1079-5014","type":"print"},{"value":"1758-5368","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,10,1]]}}}