Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada.
Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada.
J Am Geriatr Soc. 2024 Nov;72(11):3335-3345. doi: 10.1111/jgs.19155. Epub 2024 Aug 23.
There are likely many contributors to variation in the rate of cognitive decline in middle and late adulthood, including individual and neighborhood socio-economic factors. This study examines whether individual socio-economic factors, namely income and wealth, correlate with cognitive decline, in part, through neighborhood-level social and material disadvantage.
Using the three waves of data collection from the Canadian Longitudinal Study on Aging (CLSA), this study included 51,338 participants between the age of 45 and 85 years at baseline (51% female). Individual socio-economic status (SES) was assessed by annual household income and by the current value of savings and investments. Neighborhood disadvantage was measured by area-based material and social deprivation indices. Cognition was measured at each wave using verbal fluency, mental alternations, and delayed word recall. Latent change score models, incorporating direct and indirect pathways, were constructed to estimate the indirect effect of individual SES on cognitive change through area-level disadvantage. Multi-group models were constructed on the basis of age-group (45-64 years; 65-74 years; or 75+ years) to allow for varying estimates across age.
Among 45-64-year-olds, income and wealth had indirect effects on initial cognitive level and on rate of cognitive decline through material disadvantage (standardized indirect effects = 0.01, p < 0.001), but only wealth had an indirect effect through social disadvantage (p = 0.019). Among 65-74-year-olds, income and wealth had indirect effects on initial cognitive level (p < 0.01) but not on rate of cognitive decline (p > 0.05), and among 75+ year-olds, no indirect effects were observed (p > 0.05). Wealth and income had direct effects, independent of neighborhood disadvantage, on cognition in all age groups (p < 0.05).
Among middle-aged adults, greater individual SES may mitigate cognitive decline, in part, by allowing individuals to live in more materially and socially advantaged neighborhoods.
导致中年和晚年认知能力下降速度存在差异的因素可能有很多，包括个体和社区的社会经济因素。本研究通过考察个体社会经济因素（即收入和财富）是否通过社区层面的社会和物质劣势与认知能力下降相关，部分解释了这一现象。
本研究使用加拿大老龄化纵向研究（CLSA）的三波数据，共纳入了 51338 名年龄在 45 至 85 岁之间的参与者（女性占 51%）。个体社会经济地位（SES）通过家庭年收入和储蓄投资的当前价值来评估。社区劣势通过基于区域的物质和社会剥夺指数来衡量。认知能力在每一波中都通过词语流畅性、心理交替和延迟词语回忆进行测量。构建潜在变化得分模型，包括直接和间接途径，以估计个体 SES 通过区域水平劣势对认知变化的间接影响。基于年龄组（45-64 岁；65-74 岁；75 岁及以上）构建多组模型，允许年龄不同的人群进行不同的估计。
在 45-64 岁的人群中，收入和财富通过物质劣势对初始认知水平和认知下降速度有间接影响（标准化间接影响=0.01，p<0.001），但只有财富通过社会劣势有间接影响（p=0.019）。在 65-74 岁的人群中，收入和财富对初始认知水平有间接影响（p<0.01），但对认知下降速度没有影响（p>0.05），而在 75 岁及以上的人群中，没有观察到间接影响（p>0.05）。在所有年龄组中，财富和收入对认知有直接影响，独立于社区劣势（p<0.05）。
在中年人群中，较高的个体 SES 可能通过允许个体居住在物质和社会条件更优越的社区来减轻认知能力下降，部分解释了这一现象。
