US seniors 'smarter' than their English peers: study

June 25, 2009

U.S. seniors performed significantly better than their counterparts in England on standard tests of memory and cognitive function, according to a new study.

The study is the first known international comparison of cognitive function in nationally representative samples of older adults in the United States and England. The report is published in the June 25 peer-reviewed journal BMC Geriatrics.

"The better cognitive performance of U.S. adults was surprising since U.S. adults had a higher prevalence of cardiovascular risk factors, which are generally associated with and poorer mental function," says University of Michigan researcher Kenneth Langa, lead author of the study.

For the study, Langa and colleagues compared data on 8,299 Americans age 65 and older with 5,276 British seniors. The same cognitive tests were administered to the two groups in the same year.

The U.S. advantage in "brain health" was greatest for the oldest old---those age 85 and older. On a population level, the overall difference in cognitive performance between the two countries was quite large---approaching the magnitude associated with about 10 years of aging.

In other words, the cognitive performance of 75-year-olds in the U.S. was as good, on average, as that of 65-year-olds in England.

Data on the U.S. population came from the Health and Retirement Study, conducted by the U-M Institute for Social Research (ISR) and funded by the National Institute on Aging (NIA). Data on the U.K. study was from the English of Ageing. Both are nationally representative, population based studies designed to facilitate direct comparisons of health, wealth and well-being among older men and women.

"This study is an important step in helping to define national differences in aging and cognition," said Richard Suzman, director of the NIA's Division of Behavioral and Social Research. "Additional research is needed among these and other national surveys to identify the factors that interact to affect cognitive change in older people."

Older adults in both countries took tests of immediate and delayed recall of 10 common nouns. These included: hotel, river, tree, skin, gold, village, baby and table. Participants in the study heard the words spoken and were asked to repeat as many as possible immediately. Then they completed other survey questions and five minutes later, were asked to repeat as many of the words as possible. During the interview, participants were asked for the current day, date, month and year. Taken together, their answers (10 points for immediate recall, 10 for delayed recall, and four for orientation) made up a 24-point scale of cognitive function.

The researchers compared scores stratified by age, gender and education as well as country. The mean score for the combined cognitive scale was 12.5 (out of 24) for the youngest group of English adults (ages 65-74) and 8.3 for the oldest group (age 85 and older). The mean scores for the youngest and oldest groups in the United States were 13.8 and 10.1, respectively.

Higher levels of education and net worth in the United States accounted for some of the better cognitive performance of U.S. adults, according to Langa, a professor of medicine at the U-M Medical School, a research investigator at the VA Ann Arbor Healthcare System, and a faculty associate at the U-M ISR.

The research team also examined data on participant health conditions, risk factors and treatments for stroke, diabetes, heart disease, hypertension, lung disease and cancer. They also collected data on recent symptoms of depression, and on smoking status, alcohol consumption, and limitations in performing common activities of daily living, including dressing, bathing, taking medications and managing money.

U.S. adults reported significantly lower levels of depressive symptoms than English adults, and according to Langa, this may have accounted for some of the U.S. advantage in brain health since depression is linked with worse cognitive function.

"Other studies conducted in the mid-1990s have found that fewer than 15 percent of depressed adults in English samples received medication to treat their depression, compared to nearly 75 percent of depressed U.S. adults," Langa said. "Future research should explore whether more widespread use of anti-depressant medication in the U.S. may be one reason for the lower level of depressive symptoms, and in turn, the better of older U.S. adults compared to older English adults."

Langa and colleagues also found significant differences in alcohol consumption between the U.S. and English seniors. More than 50 percent of U.S. seniors reported no alcohol use, compared to only 15.5 percent of English seniors. Previous research has shown that moderate alcohol consumption, compared to abstinence, is linked with better cognition among those aged 50 and over.

ISR economist David Weir, director of the Health and Retirement Study and a co-author of the analysis, noted that other ongoing research by ISR economist Robert Willis suggests there may be a connection between early retirement and early onset of cognitive decline. This provides another possible explanation for lower cognition at older ages in England where retirement occurs earlier than in the United States.

Finally, Langa noted, while U.S. adults reported a higher prevalence of hypertension, they also were more likely to be taking medications to treat the condition. A number of studies have shown a link between untreated hypertension and an increased risk for cognitive impairment.

"The fact that the greatest cognitive advantage for U.S. adults was among the oldest-old may support the hypothesis that more aggressive diagnosis and treatment of hypertension, and possibly other cardiovascular risks, leads to less cognitive decline," Langa said.

"Given the growing number of older adults worldwide, future cross-national studies aimed at identifying the medical and social factors that might prevent or delay cognitive decline in older adults would make important and valuable contributions to public health."

More information: Cognitive health among older adults in the United States and in England, Kenneth M Langa, David J Llewellyn, Iain A Lang, David R Weir, Robert B Wallace, Mohammed U Kabeto and Felicia A Huppert, BMC Geriatrics (in press),

Source: University of Michigan (news : web)

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3 / 5 (2) Jun 25, 2009
hmmmm I wonder if they controlled for longer lifespan in Britain? Effects of different healthcare delivery / insurance systems? Population diversity?
5 / 5 (2) Jun 25, 2009
US beat Spain in football too.
not rated yet Jun 25, 2009
hmmmm I wonder if they controlled for longer lifespan in Britain? Effects of different healthcare delivery / insurance systems? Population diversity?

I'd say this generally answers your question as it addresses the differences in healthcare delivery.

"The fact that the greatest cognitive advantage for U.S. adults was among the oldest-old may support the hypothesis that more aggressive diagnosis and treatment of hypertension, and possibly other cardiovascular risks, leads to less cognitive decline,"

The medical insurance/healthcare delivery program for the elderly in the US (65 or older) isn't rationed (yet), as it is in the Country formerly known as England.
not rated yet Jun 26, 2009
Well, Obama is going to solve THIS problem!
Obamacare will ensure that US seniors perform at or below the level of their European peers. Thank goodness we Americans will finally have equality!
not rated yet Jun 26, 2009
This disparity shows that the study was poorly designed. The questionnaire was not in the style of questioning that Britons are schooled. British schooling emphasizes explanations of learned material, essay writing, debate, critical thinking and opinion. Brits do not take SAT style tests as kids. Multiple choice questions are rarely, if ever, used. Instead, Brits are taught, and expected, to explain and display their ability to sort, implement and discourse intelligently about any data learned. Thus, Brits are trained to recognize importance and relevance of information- not memorize meaningless strings of unrelated information. British education trains the mind to sort and identify what is important in information. Multiple choice examination was found to pass the least intelligent students who can memorize short term info without necessarily understanding it. Whereas the essay was found to identify the intelligent pupil form the memorizer. The study would be better served by asking Brits to write a 2 hour essay where they intelligently use information as the essay is the centerpiece of British education. In Briton it is not enough to memorize, kids have to show they can use the information. Thus, they have better trained minds regardless of their native intelligence. In exam, it is the 2 hour essay (rather than multiple choice) that successfully weeds out the larger pool of mindless memorizers and identifies the fewer, more brilliant minds, who can employ information in a useful way.
not rated yet Jun 26, 2009
There are other factors. 65 years ago was 1944. I can assure you that Britain had other things on its mind than memorizing things for multi-choice whilst the US sat on the fence.
Also the UK mind is honed to memorize football (aka soccer) and cricket results. Locations of pubs. If you asked the englishman to remember 10 premier league soccer players then you get close to 100% recall.
5 / 5 (1) Jun 26, 2009
Ah, I don't think the "US sat on the fence" during 1944. They were dieing at Normandy saving Britain's butt. Looks like googleplex is a Brit Senior.
1 / 5 (1) Jun 28, 2009
mtulloch - I honesty think Obama's plan is far too easy on our seriously flawed health care system. Be careful about your sources of information. There is plenty of industry propaganda being passed on as news these days. Diet is not getting enough attention also. I mean, does a loaf of bread really need to have high fructose corn syrup in it? Too many people here are fat / diabetic. The infant mortality rate is appalling for such a capable country. Medical bills are the leading cause of bankruptcy. And from personal experience I consider most treatment to be expensive and worthless. Industry is incapable of regulating itself.
Anybody telling you different is delusional or on someone's payroll.
not rated yet Jun 29, 2009
Ivytower, you have successfully the American higher education system; liberal arts, that is to say, comprehensive, education is the cornerstone of the US system. No graduate of an American university receives a bachelor degree without having taken course in philosophy, history, fine arts, natural and social sciences, and so on...all in addition to the student's core studies (e.g., physics, biology, economics, etc.). In constrast, [my understanding of] the British system is that it is based largely on rote learning. Certainly, recent British colonies, such as India, have maintained this system to the present day, resulting in graduates who are very good at memorization and receiving instruction, yet profoundly unable to think critically.

Anyhow, the article seems to focus more on memory than anything else, which is related to, but not equal with, overall cognitive ability. Methinks the correct interpretation of the data would be to conclude that US seniors are marginally better in silly memory tests.

And googleplex, please keep in mind that the only reason there is a UK today is because millions of Americans and Canadians poured into your country to fight a war you helped to start (again, since Britain was similarly integral to the outbreak of WWI). We held off fighting your war because we didn't want any part of your pettty politics. Still, we supplied you with massive amounts of industrial supplies and food. And when we joined the war after being directly attacked (waiting was and is the moral choice), we mobilized millions to fight, and win, a war in three different theaters (Africa, Europe, and the Pacific). But, please, forgive us for not saving your butts (again!) more quickly from your own shortsightedness and sabre rattling!
not rated yet Jun 30, 2009
Wow mention WW2 and I get flamed! All I was trying to say was that questionnaires can be worded to get the answer you want.
Saying sitting on the fence was insensitive.
I think it is a widely accepted historical fact that the US (along with everyone else) thought Britain would fold like the rest of Europe. It wasn't until Winny made a stand that the US realized they would put up a fight.
Of course the only way to join in the big scrap was under Artilce 1, SS8 of our constitution. So USA had to wait until there was sufficient public opinion for a vote to pass in the House.
Yes I am fully aware of the lease loan agreement provided by the USA to Britain.
And no Mtullock I am not a senior!
not rated yet Jul 21, 2009
Hyperion1110- The British education was the more effective model for the less effective American educational system. The English are a tiny island with a small population, yet they gave the world the highest (per capita) number of individuals on the list of the most influential persons in history. The British educational system was a keystone to unlock modern science, modern medicine, modern capitalism and economics. The globalization of the world really means the Angloization of the world via the British Empire upon which the sun never set and the U.S. was its mere child. The US Constitution was written-- by Englishmen. The US has a gigantic population. So, even with a poor education system it can produce a few (per capita) number of scientists. The US It ranks very low on international standards of education. A college degree in the US usually means the educational equivalent of an 8th grader in Germany and Japan. It is essential that Americans recover some semblance of true education, rather than just handing out college degrees the way phony high school diplomas are handed out in the US. For example, UCLA only takes kids with the best grades, However, 75% of incoming freshmen to UCLA require remedial math-- meaning they don't even know ARITHMETIC. Americans now rank number 117 in math worldwide. 80% of Americans do not even know that England is an island and 75% of Americans cannot find the pacific Ocean on an unmarked globe. Europeans do NOT have this huge educational vacuum. Americans merely hand put "diplomas" for showing up. This is a real problem that is not served by artificial "bragging" about American education. American education is a joke worldwide. The Americans who produced American contributions to science were mostly educated in a time gone by. Besides, even in that time gone by-- Adam Smith, Pasteur, Curie, Einstein, Planck, Bohr, Faraday, Newton, Leipnitz, Werner von Braun, etc, etc were all Europeans. Remember, modern science was born in Europe. And some of those Europeans brought European culture, European science, European craftsmanship, European educational means and know how-- across the Atlantic to the US. The US is what it is because it was populated by Europeans who brought European ways here. Without the European colonies, America would not be the powerhouse it is today. Those European colonies were a success and attracted immigrants from all over the world to come to the US to join the US experience, to make it even more vibrant via diversity. However, do not falsely brag about what the US does not have. Science is at great risk of extinction in America. 80% of the US population does not understand or believe in evolution. Whereas, 97% of Europeans (even the Pope) accepts the theory of evolution. Additionally, Fundamental Christianity is the largest group in the US, while fundamentalist Christianity doesn't really even exist in Europe. 80% of Europeans state themselves to be agnostic or atheist. Whereas, here in the US, 80% say they believe that Jesus and angels and that Jesus their savior and will open the door of heaven to be with God on a fluffy cloud when they die. Europeans have a much larger percentage of their populace with a more scientific mind and gave up widespread psychological dependence on the Church a long time ago. In fact, the US got the notion of the separation of Church and state from our European forebears. Stop bragging about US education-- it doesn't help anything. If we want a scientific future for the US-- we need to act together to have real education here-- not just handing out diplomas because some kid sat through a class with his iPod in his ear. The fact remains, even though US kids have "diplomas" the US population is NOT well-educated and US citizens are less scientific than nearly any other industrialized nation. Europe, Japan and China turn out more educated folks than the US right now. Instead, the US grants often hollow degrees by objective comparison.

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