Am J Epidemiol. 2023 Nov 10;192(12):2006-2017. doi: 10.1093/aje/kwad157.
The Hispanic/Latino population experiences socioeconomic adversities across the lifespan and is at greater risk of cognitive impairment, yet little is known about the role of life-course socioeconomic position (SEP) in cognitive function in this population. Using baseline data (2008-2011) from adults (aged 45-74 years) of the Hispanic Community Health Study/Study of Latinos, we assessed the association between childhood SEP and socioeconomic mobility with cognitive function, and whether this association was mediated by midlife SEP. Childhood SEP was assessed using parental education. An index combining participants' education and household income represented midlife SEP. Socioeconomic mobility was categorized as stable low, downward or upward mobility, and stable high-SEP. Cognitive function measures were modeled using survey linear regression with inverse-probability weighting, accounting for covariates. We used mediation analysis to estimate the indirect effect of childhood SEP on cognition through midlife SEP. High childhood SEP was associated with global cognition in adulthood (coefficient for parental education beyond high school vs. less than high school = 0.26, 95% confidence interval: 0.15, 0.37). This association was partially mediated through midlife SEP (indirect effect coefficient = 0.16, 95% confidence interval: 0.15, 0.18). Low SEP through the life course was associated with the lowest cognitive function. This study provides evidence that life-course SEP influences cognitive performance in adulthood.
拉美裔/西班牙裔人群在整个生命周期中都面临着社会经济逆境,认知障碍的风险更高,但对于这一人群中生活过程中的社会经济地位 (SEP) 在认知功能中的作用知之甚少。本研究使用西班牙裔社区健康研究/拉丁裔研究中成年人(年龄在 45-74 岁之间)的基线数据(2008-2011 年),评估了童年 SEP 和社会经济流动性与认知功能之间的关系,以及这种关系是否通过中年 SEP 发生中介作用。童年 SEP 用父母的教育程度来评估。一个结合参与者的教育程度和家庭收入的指数代表了中年 SEP。社会经济流动性分为稳定的低、下降或上升流动性,以及稳定的高 SEP。认知功能测量采用调查线性回归,使用逆概率加权,考虑了协变量。我们使用中介分析来估计童年 SEP 通过中年 SEP 对认知的间接影响。较高的童年 SEP 与成年后的整体认知能力相关(高中以上学历的父母教育程度系数与低于高中学历的父母教育程度系数相比=0.26,95%置信区间:0.15,0.37)。这种关联部分通过中年 SEP 发生中介作用(间接效应系数=0.16,95%置信区间:0.15,0.18)。整个生命过程中的低 SEP 与最低的认知功能相关。这项研究提供了证据表明,生活过程中的 SEP 会影响成年后的认知表现。