Department of Medical and Surgery Sciences, University of Brescia, Brescia, Italy.
J Alzheimers Dis. 2011;24(3):559-68. doi: 10.3233/JAD-2011-101863.
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.
1200 名无痴呆的老年人（60-98 岁）参与了因奇安蒂研究（意大利），他们在基线（1998-2000 年）和 3 年随访（2001-2003 年）时进行了评估，目的是分析终身社会经济地位（SES）与现患和新发认知障碍但无痴呆（CIND）的关系。SES 根据受教育程度、最长任职时间和终身财务状况等信息确定。CIND 定义为年龄调整后的简易精神状态检查得分低于无痴呆参与者的基线平均得分一个标准差。使用逻辑回归和 Cox 比例风险模型来估计 SES 与 CIND 的关系。人口统计学、职业特征（即工作压力和身体需求）、心血管疾病、糖尿病、载脂蛋白 E（APOE）基因型、吸烟、饮酒、抑郁症状和 C 反应蛋白被认为是潜在的混杂因素。CIND 的患病率为 17.7%。在完全调整的模型中，低教育（OR=2.1；95%置信区间，CI=1.4 至 3.2）与现患 CIND 相关。CIND 的发病率为 66.0/1000 人年。低教育（HR=1.7；95%CI=1.04 至 2.6）和体力劳动职业（HR=1.9；95%CI=1.0 至 3.6）与新发 CIND 相关。在协变量中，高工作相关的身体需求与现患和新发 CIND 相关（OR=1.6；95%CI=1.1 至 2.4 和 HR=1.5；95%CI=1.0 至 2.3）。在按教育程度分层后，在高教育程度的参与者中，体力劳动职业与 CIND 仍相关（HR=2.2；95%CI=1.2 至 4.3 与 HR=1.4；95%CI=0.2 至 10.4 在低教育程度的参与者中）。终身 SES 的代理标志物（低教育程度、体力劳动职业和高身体需求）是 CIND 的横断面相关因素，并在 3 年随访期间预测新发 CIND。
