title: Is cognitive decline in the elderly associated with contextual income? Results of a population-based study in southern Brazil.
abstract: The aim of this study was to estimate the association between contextual income and cognitive decline in the elderly in Florianópolis, a medium-sized city in southern Brazil. A nested cross-sectional study was performed in a cohort of elderly ≥ 60 years (n = 1,197), interviewed in the second wave (2013/2014) of the EpiFloripa cohort. Cognitive decline was assessed with the Mini Mental State Examination (MMSE) and contextual income was measured as the mean monthly income of the heads of households. Individual adjustment variables were sex, age, skin color, per capita household income, years of schooling, and time living in the neighborhood. The data were analyzed using multilevel logistic regression. The odds of cognitive decline were twice as high (OR = 1.99; 95%CI: 1.03; 3.87) in elderly living in census tracts with the lowest income quintile compared to those in the highest quintile, independently of individual characteristics. In conclusion, the socioeconomic environment is related to cognitive decline and should be considered in public policies with a focus on health of the elderly.
authors.affiliation: Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Danielewicz
authors.affiliation: Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Katia Jakovljevic Pudla
authors.initials: KJ
authors.lastname: Wagner
authors.affiliation: Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Eleonora
authors.initials: E
authors.lastname: d'Orsi
authors.affiliation: Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Antonio Fernando
authors.initials: AF
authors.lastname: Boing
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012959:Socioeconomic Factors