Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.
Business R&D Department, Risk Management Business Unit, Sompo Risk Management Inc, Tokyo, Japan.
Int J Geriatr Psychiatry. 2019 Nov;34(11):1642-1650. doi: 10.1002/gps.5177. Epub 2019 Jul 26.
Lower socio-economic status (SES) may be associated with dementia later in life, but there is inconsistent evidence supporting this claim. We aim to examine the association between three SESs (education, job, and income indicators) and dementia onset in older adults.
Study design was a 6-year prospective cohort study. Participants included a total of 52 063 community-dwelling adults aged 65 years or older without long-term care needs from the Japan Gerontological Evaluation Study. Outcome variable was dementia onset. Explanatory variables were educational years, the longest job held, and equivalised household income. We performed Cox proportional hazard analysis by gender with multiple imputation.
During the follow-up period, 10.5% of participants acquired dementia. The adjusted risks of dementia incidence of the participants with less than 6 years of education were 1.34 times (95% confidence interval [CI], 1.04-1.73) in men and 1.21 (1.00-1.45) times in women higher than those with more than 13 years of education. Females with less than 1.99 million yen (hazard ratio = 0.83, 0.72-0.96) of equivalised income were less likely to acquire dementia than those with four million yen or higher.
Educational attainment had a robust impact on dementia onset compared with the other SES factors in both genders of older Japanese people. Securing an education for children could be crucial to prevent dementia later in life. The longest job held was less likely to be risks of dementia incidence, compared with the other two factors.
较低的社会经济地位（SES）可能与晚年痴呆症有关，但支持这一说法的证据并不一致。我们旨在研究三种 SES（教育、工作和收入指标）与老年人痴呆症发病之间的关系。
研究设计为 6 年的前瞻性队列研究。参与者包括来自日本老年评估研究的总共 52063 名没有长期护理需求的 65 岁或以上的社区居住成年人。结果变量是痴呆症发病。解释变量是受教育年限、最长工作年限和家庭收入等价。我们按性别进行了 Cox 比例风险分析，并进行了多重插补。
在随访期间，10.5%的参与者患上了痴呆症。受教育年限少于 6 年的参与者发生痴呆症的调整风险是受教育年限大于 13 年的参与者的 1.34 倍（95%置信区间[CI]，1.04-1.73），女性为 1.21（1.00-1.45）倍。收入等价低于 199 万日元（危险比=0.83，0.72-0.96）的女性比收入等价为 400 万日元或更高的女性发生痴呆症的可能性更小。
与其他 SES 因素相比，教育程度对日本老年人的两性痴呆症发病都有很大的影响。为孩子提供教育可能对预防晚年痴呆症至关重要。与其他两个因素相比，最长工作年限不太可能是痴呆症发病的风险因素。
