title: Individual and Area Level Socioeconomic Status and Its Association with Cognitive Function and Cognitive Impairment (Low MMSE) among Community-Dwelling Elderly in Singapore.
abstract: OBJECTIVE
  Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood.
  
  
  METHODS
  The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as <24 on the Mini Mental State Examination. Demographic/clinical details were collected via questionnaire. Multilevel linear regression was used to evaluate factors associated with cognitive function, while multilevel logistic regression determined predictors of cognitive impairment.
  
  
  RESULTS
  Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = -1.41, SD = 0.58, p < 0.01) and cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98-13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected.
  
  
  CONCLUSIONS
  Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society.
authors.affiliation: Yong Loo Lin School of Medicine, National University Health System, Singapore, Singapore.
authors.forename: Liang En
authors.initials: LE
authors.lastname: Wee
authors.forename: Wei Xin
authors.initials: WX
authors.lastname: Yeo
authors.forename: Gui Rong
authors.initials: GR
authors.lastname: Yang
authors.forename: Nazirul
authors.initials: N
authors.lastname: Hannan
authors.forename: Kenny
authors.initials: K
authors.lastname: Lim
authors.forename: Christopher
authors.initials: C
authors.lastname: Chua
authors.forename: Mae Yue
authors.initials: MY
authors.lastname: Tan
authors.forename: Nikki
authors.initials: N
authors.lastname: Fong
authors.forename: Amelia
authors.initials: A
authors.lastname: Yeap
authors.forename: Lionel
authors.initials: L
authors.lastname: Chen
authors.forename: Gerald Choon-Huat
authors.initials: GC
authors.lastname: Koh
authors.forename: Han Ming
authors.initials: HM
authors.lastname: Shen
keywords: Asia; Cognitive impairment; Neighborhood; Socioeconomic status