Hofbauer Lena M, Rodriguez Francisca S
German Center for Neurodegenerative Diseases (DZNE), Ellernholzstr 1-2, 17489Greifswald, Germany.
Int Psychogeriatr. 2021 Dec;33(12):1309-1320. doi: 10.1017/S1041610221000995. Epub 2021 Sep 8.
Previous work using a US sample has shown that an index of social deprivation (SoDep Index) is associated with cognitive functioning and decline in older adults. This study aimed to replicate these findings using a European sample (Survey of Health, Ageing and Retirement in Europe, SHARE).
We analyzed data of 51,630 respondents aged 50 years and older (M: 63.5 years, standard deviation [SD]: 9.1) with at least two cognitive assessments (follow-up M: 6.06 years, SD: 3.86). Cognitive scores were transformed to Z-scores. Multiple growth curve modeling was used to model cognitive status and decline as predicted by the SoDep Index. In a sensitivity analysis, we constructed a new SoDep Index (SoDep Indexnew) including further social deprivation domains.
Adjusting for covariates, a unit increase in SoDep Index was associated with a cognitive score of 0.037 SDs smaller (p < .001) and a decline 0.003 SDs per year faster (p < .001). Of the covariates, depressive symptoms, chronic disease burden, male gender, and widowhood were also associated with poorer cognition. Being divorced was associated with better cognition. Sensitivity analysis confirmed findings. Compared to the SoDep Index, the SoDep Indexnew showed a more pronounced association with both cognition and cognitive decline.
We were able to replicate results showing an association between SoDep Index and cognitive function and decline. The sensitivity analysis further emphasizes the relevance of financial security. This strengthens the implication that preventing social deprivation can contribute to reducing the dementia burden by raising cognitive functioning in the older population. The findings are relevant to policy-makers and health care practitioners.
此前使用美国样本进行的研究表明，社会剥夺指数（SoDep指数）与老年人的认知功能及认知衰退有关。本研究旨在使用欧洲样本（欧洲健康、老龄化与退休调查，SHARE）重复这些研究结果。
我们分析了51630名年龄在50岁及以上（平均年龄：63.5岁，标准差[SD]：9.1）且至少接受过两次认知评估的受访者的数据（随访平均时间：6.06年，SD：3.86）。认知分数被转换为Z分数。使用多重增长曲线模型来模拟由SoDep指数预测的认知状态和衰退情况。在敏感性分析中，我们构建了一个新的SoDep指数（SoDep Indexnew），纳入了更多社会剥夺领域。
在对协变量进行调整后，SoDep指数每增加一个单位，认知分数会降低0.037个标准差（p <.001），且每年衰退速度加快0.003个标准差（p <.001）。在协变量中，抑郁症状、慢性病负担、男性性别和丧偶也与较差的认知功能有关。离婚则与较好的认知功能有关。敏感性分析证实了研究结果。与SoDep指数相比，SoDep Indexnew与认知及认知衰退的关联更为显著。
我们成功重复了SoDep指数与认知功能及衰退之间存在关联的结果。敏感性分析进一步强调了经济安全的相关性。这强化了预防社会剥夺可通过提高老年人群的认知功能来减轻痴呆负担的这一观点。这些研究结果对政策制定者和医疗从业者具有参考价值。
