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By James E Spar; Asenath La Rue

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Education, Work, and Financial Status The average education level of older Americans has increased in recent decades; in 2003, nearly three-fourths of persons age 65 and older had a high school diploma. Older Asian Americans had the highest percentage of persons (29%) with at least a bachelor’s degree. By contrast, older black and Hispanic Americans remained disadvantaged in terms of education (Figure 2–1). In industrialized countries, participation of older men in the labor force has declined in recent decades.

In one large multicultural study, most old persons without dementia who had less than 5 years of education were rated with standard mental status examinations as impaired (Wilder et al. 1995). Among healthy, well-educated old persons, brief cognitive screening may fail to detect focal brain impairment or dementia in early stages. For example, as many as one in three older patients with mild Alzheimer’s disease who are otherwise healthy and have at least a high school education can be expected to score in the normal range on very brief tests for cognitive screening.

9) may be coded to denote functioning of an older person with mild cognitive changes that are within normal limits for age and not attributable to a medical disorder. No guidelines have been developed for identifying age-related cognitive decline. However, diagnostic criteria have been proposed for a related, but narrower, category of age-associated memory impairment (AAMI). Persons with a diagnosis of AAMI must be 50 years or older, have subjective complaints of memory loss affecting routine activities, and perform below the average level of young adults on a standardized memory test; exclusionary criteria include any neurological, psychiatric, or medical disorders that could reasonably be assumed to be producing the memory change.

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