title: Socioeconomic status during lifetime and cognitive impairment no-dementia in late life: the population-based aging in the Chianti Area (InCHIANTI) Study.
abstract: Thousand and twelve dementia-free elderly (60–98 years old) enrolled in the InChianti Study (Italy) were evaluated at baseline (1998–2000) and at 3-year follow-up (2001–2003) with the aim of analyzing the association of lifetime socioeconomic status (SES) with prevalent and incident cognitive impairment no-dementia (CIND). SES was defined from information on formal education, longest held occupation, and financial conditions through life. CIND was defined as age-adjusted Mini-Mental State Examination score one standard deviation below the baseline mean score of participants without dementia. Logistic regression and Cox proportional-hazards models were used to estimate the association of SES with CIND. Demographics,occupation characteristics (i.e., job stress and physical demand), cardiovascular diseases, diabetes, apolipoprotein E (APOE)genotype, smoking, alcohol consumption, depressive symptoms, and C-reactive protein were considered potential confounders.Prevalence of CIND was 17.7%. In the fully adjusted model, low education (OR = 2.1; 95% confidence intervals, CI = 1.4 to 3.2)was associated with prevalent CIND. Incidence rate of CIND was 66.0 per 1000 person-years. Low education (HR = 1.7; 95% CI = 1.04 to 2.6) and manual occupation (HR = 1.9; 95% CI = 1.0 to 3.6) were associated with incident CIND. Among covariates,high job-related physical demand was associated with both prevalent and incident CIND (OR = 1.6; 95% CI = 1.1 to 2.4 and HR= 1.5; 95% CI = 1.0 to 2.3). After stratification for education, manual occupation was still associated with CIND among participants with high education (HR = 2.2; 95% CI = 1.2 to 4.3 versus HR= 1.4; 95% CI = 0.2 to 10.4 among those with low education). Proxy markers of lifetime SES (low education, manual occupation and high physical demand) are cross-sectional correlates of CIND and predict incident CIND over a three-year follow-up.
authors.affiliation: Department of Medical and Surgery Sciences, University of Brescia, Brescia, Italy. alessandra.marengoni@ki.se
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
authors.forename: Laura
authors.initials: L
authors.lastname: Fratiglioni
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003072:Cognition Disorders / Q000453:epidemiology*; D018672:Community Health Planning; D004522:Educational Status; D005260:Female; D005376:Financial Management; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009790:Occupations; D016017:Odds Ratio; D012189:Retrospective Studies; D012923:Social Class; D013223:Statistics as Topic; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein