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认知差异:大萧条和累积不平等对晚年认知功能的影响

Cognitive Disparities: The Impact of the Great Depression and Cumulative Inequality on Later-Life Cognitive Function.

作者信息

Hale Jo Mhairi

机构信息

Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.

Department of Sociology, University of California, Davis, CA, USA.

出版信息

Demography. 2017 Dec;54(6):2125-2158. doi: 10.1007/s13524-017-0629-4.

Abstract

Population aging has driven a spate of recent research on later-life cognitive function. Greater longevity increases the lifetime risk of memory diseases that compromise the cognitive abilities vital to well-being. Alzheimer's disease, thought to be the most common underlying pathology for elders' cognitive dysfunction (Willis and Hakim 2013), is already the sixth leading cause of death in the United States (Alzheimer's Association 2016). Understanding social determinants of pathological cognitive decline is key to crafting interventions, but evidence is inconclusive for how social factors interact over the life course to affect cognitive function. I study whether early-life exposure to the Great Depression is directly associated with later-life cognitive function, influences risky behaviors over the life course, and/or accumulates with other life-course disadvantages. Using growth curve models to analyze the Health and Retirement Study, I find that early-life exposure to the Great Depression is associated with fluid cognition, controlling for intervening factors-evidence for a critical period model. I find little support for a social trajectory model. Disadvantage accumulates over the life course to predict worse cognitive function, providing strong evidence for a cumulative inequality model.

摘要

人口老龄化推动了近期一系列关于晚年认知功能的研究。更长的寿命增加了患记忆疾病的终身风险,这些疾病会损害对幸福至关重要的认知能力。阿尔茨海默病被认为是老年人认知功能障碍最常见的潜在病理原因(威利斯和哈基姆,2013年),它已经是美国第六大死因(阿尔茨海默病协会,2016年)。了解病理性认知衰退的社会决定因素是制定干预措施的关键,但关于社会因素如何在生命历程中相互作用以影响认知功能的证据尚无定论。我研究早年经历大萧条是否与晚年认知功能直接相关,是否会影响生命历程中的危险行为,和/或与其他生命历程中的不利因素累积。通过使用增长曲线模型分析健康与退休研究,我发现早年经历大萧条与流体认知相关,同时控制了中间因素——这为关键期模型提供了证据。我几乎没有找到支持社会轨迹模型的证据。不利因素在生命历程中累积,预示着更差的认知功能,这为累积不平等模型提供了有力证据。

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