Inserm, Bordeaux Population Health Research Center, team Psychoepidemiology of aging and chronic diseases, University of Bordeaux, France.
Department of Geriatrics, National Institute of Medical Sciences and Nutrition "Salvador Zubiran", Mexico City, Mexico.
J Gerontol B Psychol Sci Soc Sci. 2020 Jan 1;75(1):218-227. doi: 10.1093/geronb/gbx130.
To determine the impact of both individual psychosocioeconomic precariousness and geographical deprivation on risk of dementia in older adults followed-up for 25 years.
The sample consisted of 3,431 participants aged 65 years or over from the PAQUID cohort study. Individual psychosocioeconomic precariousness was measured computing eight economic and psychosocial indicators. Geographical deprivation was assessed by the FDep99 index, consisting of four community socioeconomic variables. For both measures, the fourth quartile of the distribution was considered as the more precarious or deprived category, while the first quartile was considered as the less precarious or deprived one. Clinical dementia diagnosis was assessed all along study follow-up. The association between individual psychosocioeconomic precariousness, geographical deprivation and risk of dementia was assessed using illness-death regression models adjusted for age, sex, depression, psychotropic drug consumption, comorbidities, disability, and body mass index, while accounting for death as a competing event.
The risk of dementia was higher for the more psychosocioeconomic precarious participants (HR = 1.51; 95% CI: 1.24-1.84). No increased risk of dementia was found for those living in communities with high index of deprivation.
Psychosocioeconomic precariousness, but not geographical deprivation, is associated with a higher risk of dementia.
确定个体心理社会经济脆弱性和地理剥夺程度对随访 25 年的老年人痴呆风险的影响。
该样本由来自 PAQUID 队列研究的 3431 名 65 岁或以上的参与者组成。个体心理社会经济脆弱性通过计算 8 个经济和心理社会指标来衡量。地理剥夺程度通过 FDep99 指数评估，该指数由四个社区社会经济变量组成。对于这两个指标，分布的第四四分位数被认为是更脆弱或更贫困的类别，而第一四分位数被认为是不太脆弱或贫困的类别。在整个研究随访期间评估临床痴呆诊断。使用疾病死亡回归模型评估个体心理社会经济脆弱性、地理剥夺与痴呆风险之间的关联，该模型调整了年龄、性别、抑郁、精神药物使用、合并症、残疾和体重指数，并考虑了死亡作为竞争事件。
更具心理社会经济脆弱性的参与者痴呆风险更高（HR=1.51；95%CI：1.24-1.84）。居住在剥夺程度较高社区的人痴呆风险没有增加。
心理社会经济脆弱性，而不是地理剥夺，与更高的痴呆风险相关。
