From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
Neurology. 2019 Nov 12;93(20):e1890-e1899. doi: 10.1212/WNL.0000000000008463. Epub 2019 Oct 2.
Income volatility presents a growing public health threat. To our knowledge, no previous study examined the relationship among income volatility, cognitive function, and brain integrity.
We studied 3,287 participants aged 23-35 years in 1990 from the Coronary Artery Risk Development in Young Adults prospective cohort study. Income volatility data were created using income data collected from 1990 to 2010 and defined as SD of percent change in income and number of income drops ≥25% (categorized as 0, 1, or 2+). In 2010, cognitive tests (n = 3,287) and brain scans (n = 716) were obtained.
After covariate adjustment, higher income volatility was associated with worse performance on processing speed (β = -1.09, 95% confidence interval [CI] -1.73 to -0.44) and executive functioning (β = 2.53, 95% CI 0.60-4.50) but not on verbal memory (β = -0.02, 95% CI -0.16 to 0.11). Similarly, additional income drops were associated with worse performance on processing speed and executive functioning. Higher income volatility and more income drops were also associated with worse microstructural integrity of total brain and total white matter. All findings were similar when restricted to those with high education, suggesting reverse causation may not explain these findings.
Income volatility over a 20-year period of formative earning years was associated with worse cognitive function and brain integrity in midlife.
收入波动带来了日益严重的公共健康威胁。据我们所知，以前没有研究探讨过收入波动、认知功能和大脑完整性之间的关系。
我们研究了 1990 年来自“年轻人冠状动脉风险发展”前瞻性队列研究的 3287 名 23-35 岁的参与者。使用 1990 年至 2010 年期间收集的收入数据创建了收入波动数据，并将其定义为收入变化百分比的标准差和收入下降次数≥25%（分为 0、1 或 2+）。2010 年，获得了认知测试（n=3287）和脑部扫描（n=716）。
在调整了协变量后，较高的收入波动与处理速度（β=-1.09，95%置信区间[CI] -1.73 至 -0.44）和执行功能（β=2.53，95%CI 0.60-4.50）的表现更差相关，但与言语记忆无关（β=-0.02，95%CI -0.16 至 0.11）。同样，额外的收入下降与处理速度和执行功能的表现更差相关。较高的收入波动和更多的收入下降也与大脑和总白质的微观结构完整性较差相关。当限制在高学历人群中时，所有发现均相似，表明反向因果关系可能无法解释这些发现。
在形成收入的 20 年期间，收入波动与中年认知功能和大脑完整性较差有关。
