1. Life-Course Individual and Neighborhood Socioeconomic Status and Risk of Dementia in the Atherosclerosis Risk in Communities Neurocognitive Study.
- Author
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George, Kristen M, Lutsey, Pamela L, Kucharska-Newton, Anna, Palta, Priya, Heiss, Gerardo, Osypuk, Theresa, and Folsom, Aaron R
- Subjects
Prevention ,Neurosciences ,Aging ,Behavioral and Social Science ,Clinical Research ,Brain Disorders ,Cardiovascular ,Acquired Cognitive Impairment ,Dementia ,Black or African American ,Female ,Humans ,Male ,Middle Aged ,Prospective Studies ,Residence Characteristics ,Risk Assessment ,Social Class ,United States ,White People ,dementia ,disparities ,life course ,socioeconomic status ,Mathematical Sciences ,Medical and Health Sciences ,Epidemiology - Abstract
We examined associations of individual- and neighborhood-level life-course (LC) socioeconomic status (SES) with incident dementia in the Atherosclerosis Risk in Communities cohort. Individual- and neighborhood-level SES were assessed at 3 life epochs (childhood, young adulthood, midlife) via questionnaire (2001-2002) and summarized into LC-SES scores. Dementia was ascertained through 2013 using cognitive exams, telephone interviews, and hospital and death certificate codes. Cox regression was used to estimate hazard ratios of dementia by LC-SES scores in race-specific models. The analyses included data from 12,599 participants (25% Black) in the United States, with a mean age of 54 years and median follow-up of 24 years. Each standard-deviation greater individual LC-SES score was associated with a 14% (hazard ratio (HR) = 0.86, 95% confidence interval (CI): 0.81, 0.92) lower risk of dementia in White and 21% (HR = 0.79, 95% CI: 0.71, 0.87) lower risk in Black participants. Education was removed from the individual LC-SES score and adjusted for separately to assess economic factors of LC-SES. A standard-deviation greater individual LC-SES score, without education, was associated with a 10% (HR = 0.90, 95% CI: 0.84, 0.97) lower dementia risk in White and 15% (HR = 0.85, 95% CI: 0.76, 0.96) lower risk in Black participants. Neighborhood LC-SES was not associated with dementia. We found that individual LC-SES is a risk factor for dementia, whereas neighborhood LC-SES was not associated.
- Published
- 2020