This study examined whether depressive symptoms and cognitive performance remain distinct or show dimensional overlap among older Black adults (n=265, mean age=69, 72% women) in the Health and Retirement Study (2006–2020), stratified by three types of adverse policing exposure: historical lynching, disproportionate state-level police killings, and self-reported lifetime negative law enforcement encounters.
Depressive and cognitive items mostly loaded onto separate factors across all exposure groups, but effort-related depressive items ('felt activities were efforts,' 'felt unmotivated') and executive-function cognitive tasks (serial 7s, backwards counting) consistently cross-loaded, especially among those exposed to state-level police killings (3-factor solution) and those with all three adverse policing exposures (n=20; highest depressive symptoms mean=2.15, lowest cognitive scores mean=13.40, poorest model fit overall).
- Very small subgroups (n=20 for cumulative exposure, n=36 for individual-level encounters) limit stability and generalizability of factor solutions. - Anxiety, hypervigilance, and trauma-related symptoms were not measured, so cross-loading patterns cannot be cleanly attributed to depression versus trauma responses. - All CFA models showed poor-to-marginal absolute fit (RMSEA, TLI, CFI), so findings are exploratory and hypothesis-generating only.
Standard depression and cognitive screening tools (CES-D, modified TICS) may not cleanly separate depressive from cognitive symptoms in older Black adults with chronic exposure to adverse policing—clinicians should interpret effort- and motivation-related items with caution in this population. Incorporating structural racism exposures into dementia risk assessments may improve diagnostic equity.
Explore related topics
