Alzheimer Disease and Associated Disorders · Nov 12, 2025

County-level School Quality Education Measures During Ninth Grade and Brain Health Imaging Markers in Late Life

By LaPoint MR, Roscoe JN, Whitmer RA et al.

OBJECTIVES: Education quality varies across the United States, both by state and by race/ethnicity, and it is unclear what impacts, if any, this may have on the brain in later life. In this study, we investigated the association between ninth-grade county-level education quality and brain health in 2 racially/ethnically diverse cohorts of older adults (n = 450, ages 61 to 102). METHODS: Historical county-level measures of education quality (percentage attendance, teacher-student ratio, and term length) were linked to total gray matter volume, ventricular volume, hippocampal volume, white matter hyperintensities, free water, and fractional anisotropy using linear regression models with robust SEs, adjusting for demographic factors, childhood socioeconomic status, state history of de jure school segregation, and study cohort. RESULTS: Teacher-student ratio and term length were not associated with brain imaging measures in fully adjusted models. Higher percentage attendance was associated with higher free water (β = 0.05, 95% CI: 0.0006, 0.09) and larger ventricular volume (β = 1.50, 95% CI: 0.41, 2.59). CONCLUSIONS: Though these relationships were not in the expected direction, they provide some evidence that education quality may be associated with brain health at older ages.

doi.org/10.1097/wad.0000000000000703Open access, accepted manuscriptPubMed 41222104Populations