Discrimination, hypertensive disorders of pregnancy, and cognition in midlife women
Bibliographic record
Abstract
BACKGROUND: Profound and persistent disparities in late-life brain health exist by gender/sex and racialized group. Hypertensive disorders of pregnancy (HDP), which disproportionately impact Black women, have recently been recognized as a sex-specific midlife risk factor for Alzheimer's disease and related dementias (ADRD). Furthermore, discrimination is an emerging risk factor for both HDP and later poor cognitive health. We aimed to assess associations of discrimination with cognition in midlife women, independent of HDP. METHOD: Participants (n = 580) were recruited from a clinical cohort at Magee-Womens Hospital, Pittsburgh, PA. Births occurred 2008-2012, with demographics, the Everyday Discrimination Scale (EDS; a measure of day-to-day discrimination experiences), the telephone Montreal Cognitive Assessment (T-MoCA; an objective cognitive measure), and the Everyday Cognition Scale (ECog; a subjective cognitive measure) completed in 2024. We tested association of discrimination with cognition using linear regression models adjusting for age, education, race, and HDP. We explored associations of discrimination with domains of subjective cognitive performance on the ECog including: organization, planning, divided attention, memory, language, and visuospatial and perceptual abilities. RESULT: Participants were 42.6±6.2 years old, 14.0±1.4 years post-partum, and 51.4% had≥college education (Table 1). Self-identified race was Black (n = 150 (25.9%)) compared to non-Black participants [n = 430 (74.1%), White (n = 415), Latina (n = 5), Asian (n = 9), or American Indian (n = 1)] due to small numbers of some groups. Black women more commonly endorsed race as the cause of the discrimination vs. non-Black women (62.7% vs. 5.6%, p < .0001), while non-Black women more commonly endorsed gender as the cause of the discrimination vs. Black women (32.6% vs. 18.0%, p = 0.007). In fully adjusted models, EDS was not significantly associated with T-MoCA score (p = 0.59, Table 2), but greater discrimination reported on the EDS was significantly associated with greater (worse) ECog scores (p < .0001). Greater EDS was significantly associated with worse ECog scores across all domains examined (Table 3). In fully adjusted models, the largest effect sizes were seen in everyday organization, memory, divided attention, and planning. CONCLUSION: Subjective cognitive measures (vs. objective) were more sensitive to associations with discrimination. Executive and memory domains were most strongly associated, indicating that discrimination may have implications for day-to-day function and risk of cognitive impairment before late-life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".