Meyer Oanh L, Mungas Dan, King Jesse, Hinton Ladson, Farias Sarah, Reed Bruce, DeCarli Charles, Geraghty Estella, Beckett Laurel
a University of California , Davis School of Medicine , Sacramento , California , USA.
b National Institutes of Health , Bethesda , Maryland , USA.
Clin Gerontol. 2018 Jan-Feb;41(1):82-93. doi: 10.1080/07317115.2017.1282911. Epub 2017 Feb 3.
Although individual-level socioeconomic status is associated with poor outcomes, less is known regarding how the social context might affect cognitive outcomes. We examined the effect of neighborhood socioeconomic status (NSES) on baseline cognitive function and trajectories of decline.
The sample (N = 480) came from a longitudinal cohort recruited to study cognitive function. Mixed effects models examined the influence of NSES on baseline and rate of change in executive function, semantic memory, and episodic memory.
NSES was positively associated with semantic memory scores at baseline, but not with executive function or episodic memory in adjusted models, nor was it associated with cognitive change in longitudinal analyses. In exploratory analyses, for individuals with dementia, those with higher NSES declined faster in executive function and semantic memory than did those with lower NSES.
Results suggest that NSES has limited effects independent of personal characteristics; however, findings showed a complex relation of NSES and decline, with NSES effects observed only for individuals with dementia. Results are discussed in the context of cognitive reserve.
Clinical assessments of individuals who present with cognitive impairment might benefit from an understanding of the neighborhood context from which patients come.
尽管个体层面的社会经济地位与不良后果相关,但关于社会环境如何影响认知结果的了解较少。我们研究了邻里社会经济地位(NSES)对基线认知功能和衰退轨迹的影响。
样本(N = 480)来自一个为研究认知功能而招募的纵向队列。混合效应模型研究了NSES对执行功能、语义记忆和情景记忆的基线及变化率的影响。
在调整模型中,NSES与基线时的语义记忆得分呈正相关,但与执行功能或情景记忆无关,在纵向分析中也与认知变化无关。在探索性分析中,对于患有痴呆症的个体,NSES较高者在执行功能和语义记忆方面的衰退速度比NSES较低者更快。
结果表明,NSES独立于个人特征的影响有限;然而,研究结果显示NSES与衰退之间存在复杂关系,仅在患有痴呆症的个体中观察到NSES的影响。在认知储备的背景下对结果进行了讨论。
对出现认知障碍的个体进行临床评估时,了解患者所在的邻里环境可能会有所帮助。