title: Life-course socioeconomic position and incidence of dementia and cognitive impairment without dementia in older Mexican Americans: results from the Sacramento area Latino study on aging.
abstract: There have been few investigations of the link between changes in life-course socioeconomic position (SEP) and cognitive decline or incidence of dementia. The authors examined the impact of changes in life-course SEP on incidence of dementia and cognitive impairment but not dementia (CIND) over a decade of follow-up. Participants of Mexican origin (n = 1,789) were members of the Sacramento Area Latino Study on Aging cohort. Incidence of dementia/CIND was ascertained by using standard diagnostic criteria. SEP indicators at 3 life stages (childhood, adulthood, and midlife) were used to derive a measure of cumulative SEP (range, 0 to 8) and SEP mobility. Nearly 24% of the sample maintained a low SEP throughout life. Hazard ratios and 95% confidence intervals were computed from Cox proportional hazards regression models. In fully adjusted models, participants with a continuously high SEP had lower hazard ratios for dementia/CIND compared with those with a continuously low SEP at all 3 life stages (hazard ratio = 0.49, 95% confidence interval: 0.24, 0.98; P = 0.04). In age-adjusted models, participants experienced a 16% greater hazard of dementia/CIND with every 1-unit increase in cumulative SEP disadvantage across the life course (hazard ratio = 1.16, 95% confidence interval: 1.01, 1.33; P = 0.04). Early exposures to social disadvantage may increase the risk of late-life dementia.
authors: Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, 3333 California Street, Suite 280, San Francisco, CA 94118, USA. adina.zekialhazzouri@ucsf.edu
authors: Adina
authors: A
authors: Zeki Al Hazzouri
authors: Mary N
authors: MN
authors: Haan
authors: John D
authors: JD
authors: Kalbfleisch
authors: Sandro
authors: S
authors: Galea
authors: Lynda D
authors: LD
authors: Lisabeth
authors: Allison E
authors: AE
authors: Aiello
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D003072:Cognition Disorders / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D016001:Confidence Intervals; D003704:Dementia / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D017058:Mexican Americans / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012307:Risk Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis