Neuropsychology Department, CIEN Foundation, Carlos III Institute of Health, Madrid, Spain.
Neurology Department, CIEN Foundation, Carlos III Institute of Health, Madrid, Spain.
Aging Ment Health. 2021 May;25(5):814-823. doi: 10.1080/13607863.2020.1725803. Epub 2020 Feb 18.
There is strong evidence about the association between low socioeconomic status (SES) and higher risk of dementia. However, it has not been conveniently addressed so far the role of SES on the incidence of mild cognitive impairment (MCI). This study examines the impact of individual and neighbourhood dimensions of SES, as well as their interaction, on the risk of developing MCI in a sample of older adults. Data from the Vallecas Project cohort, an ongoing community-based longitudinal study for early detection of cognitive impairment and dementia, were used to build two indices of SES namely individual and neighbourhood, as well as a global SES as a combination of both, and to investigate their effects on MCI conversion by means of a multivariate-adjusted Cox proportional hazard model. A total of 1180 participants aged 70 years and older were enrolled in this study. Of these, 199 cases of MCI (16.9%) were diagnosed at any point of the follow-up. The individual and neighbourhood dimensions of SES played different roles in the dynamics of the MCI occurrence through aging. Most importantly, the risk of developing MCI was almost double for lower SES quartiles when compared to the highest one. The incidence of MCI in older adults was related to both individual characteristics and socioeconomic context. Public health strategies should be holistic and focus not only on promoting the classical individual preventive measures, but also on reducing social inequalities to foster healthy aging and reduce dementia burden.
有强有力的证据表明,社会经济地位(SES)较低与痴呆风险较高之间存在关联。然而,迄今为止,SES 对轻度认知障碍(MCI)发病率的影响尚未得到方便的解决。本研究考察了个体和邻里 SES 维度及其相互作用对老年人群体发生 MCI 的风险的影响。该研究使用了 Vallecas 项目队列的数据,该队列是一项正在进行的基于社区的纵向研究,旨在早期发现认知障碍和痴呆症,用于构建 SES 的两个指数,即个体和邻里,以及一个全球 SES 作为两者的组合,并通过多变量调整的 Cox 比例风险模型研究它们对 MCI 转化的影响。共有 1180 名年龄在 70 岁及以上的参与者参与了这项研究。在这些参与者中,199 人(16.9%)在随访期间被诊断出患有 MCI。SES 的个体和邻里维度通过衰老在 MCI 发生的动态中发挥了不同的作用。最重要的是,与最高 SES 四分位数相比,较低 SES 四分位数发生 MCI 的风险几乎增加了一倍。老年人发生 MCI 与个体特征和社会经济背景有关。公共卫生策略应该是全面的,不仅要关注促进经典的个体预防措施,还要关注减少社会不平等,以促进健康老龄化和减轻痴呆症负担。