Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
Int J Geriatr Psychiatry. 2018 Oct;33(10):1335-1345. doi: 10.1002/gps.4930. Epub 2018 Jul 3.
A prospective study was performed to examine the relationship of childhood socioeconomic status (SES) with cognition and the rate of change in a nationally representative sample of community-dwelling middle-aged and older Chinese population.
This study mainly focused on 3 composite measures of cognitive function, including Telephone Interview of Cognitive Status, word recall, and drawing a figure successfully. Childhood SES was evaluated by parental occupation and education, childhood residence, and self-evaluated financial status. We designed an analysis strategy adding predictors incrementally in different models to examine the changes of effects of childhood SES on cognition by latent growth curve models.
Finally, a total of 10 533 respondents were prospectively studied, including 5980 respondents aged 45-59 and 4553 aged 60-90. Cognition in younger cohort showed a curvilinear change, while cognition in older cohort showed a linear decline. After controlling for covariates, middle-aged respondents with higher self-evaluated financial status (β: -0.22, P < .001), better health status (β: -0.13, P < .001), higher parental education (β: 0.17 and 0.10, P < .001), who had lived in city/town before 16 years (β: 0.69, P < .001), and whose fathers engaged in nonfarming work (β: 0.43, P < .001) were associated with the better baseline cognition. Similar results were found in older cohort. Additionally, early-life SES was not associated with cognitive decline in both cohorts.
This study indicates that childhood SES is associated with mid-life and late-life baseline cognition, but it is not contributed to cognition decline. Interventions in early-life focused on improving childhood SES might have positive impacts on baseline cognition in later-life.
本前瞻性研究旨在探讨童年社会经济地位(SES)与认知功能的关系,并在具有全国代表性的社区中老年人群体中研究认知功能的变化率。
本研究主要关注认知功能的 3 项综合测量指标,包括电话认知状态测试、单词回忆和成功绘制图形。童年 SES 由父母职业和教育程度、童年居住地和自我评估的经济状况来评估。我们设计了一种分析策略,通过潜在增长曲线模型,在不同模型中逐步增加预测因子,来检验童年 SES 对认知功能的影响的变化。
最终,共有 10533 名受访者被前瞻性研究,其中 45-59 岁的受访者有 5980 人,60-90 岁的受访者有 4553 人。年轻队列的认知功能呈曲线变化,而老年队列的认知功能呈线性下降。在控制了混杂因素后,自我评估经济状况较好(β:-0.22,P<0.001)、健康状况较好(β:-0.13,P<0.001)、父母教育程度较高(β:0.17 和 0.10,P<0.001)、16 岁前在城镇居住(β:0.69,P<0.001)、父亲从事非农工作(β:0.43,P<0.001)的中年受访者与基线认知功能较好有关。在老年队列中也发现了类似的结果。此外,童年 SES 与两个队列的认知衰退无关。
本研究表明,童年 SES 与中年和老年的基线认知功能有关,但与认知功能下降无关。在生命早期关注改善童年 SES 的干预措施可能对晚年的基线认知产生积极影响。