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德国的财富、收入与痴呆症:来自一项针对高龄老人的代表性调查的纵向研究结果

Wealth, income and dementia in Germany: longitudinal findings from a representative survey among the oldest old.

作者信息

Hajek André, König Hans-Helmut, Rafnsson Snorri Bjorn, Gyasi Razak M

机构信息

Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

The Geller Institute of Ageing and Memory, School of Medicine and Biosciences, University of West London, London, UK.

出版信息

BMC Public Health. 2025 Aug 29;25(1):2965. doi: 10.1186/s12889-025-24239-1.


DOI:10.1186/s12889-025-24239-1
PMID:40883744
Abstract

BACKGROUND: There is limited knowledge on the link between wealth, as well as income, and dementia risk among the oldest old (80 years and over). The purpose of our study was to examine the association between income, wealth, and dementia among the oldest old in Germany. METHODS: We used representative longitudinal data from a survey, which aimed to assess the quality of life and subjective well-being of individuals aged 80 years and above in North Rhine-Westphalia (Germany). The length of follow-up was approximately 2 years. The sample consisted of both community-dwelling and institutionalized individuals, with a total of 943 observations included in the analysis. The average age of the participants was 86.0 years (SD: 4.0 years). Probable dementia was assessed by DemTect, a widely accepted screening instrument. Common income and wealth categories were used to quantify these variables. RESULTS: After adjusting for sociodemographic and health variables, logistic random effects regressions showed that greater wealth was associated with a lower likelihood of probable dementia (second lowest wealth quartile compared to lowest wealth quartile: OR: 0.23, 95% CI: 0.07-0.76; second highest wealth quartile: OR: 0.05, 95% CI: 0.01-0.31; highest wealth quartile: OR: 0.12, 95% CI: 0.02-0.91). In contrast, income was not significantly associated with the likelihood of probable dementia. CONCLUSION: Our study showed a link between wealth and dementia. Such knowledge can enrich poverty and inequality research within this field. More specifically, our findings lend support to evidence-based policies aiming to decrease the burden of dementia in later life through reduction in economic inequalities and better income distribution.

摘要

背景:关于财富以及收入与最年长者(80岁及以上)患痴呆症风险之间的联系,人们所知有限。我们研究的目的是调查德国最年长者的收入、财富与痴呆症之间的关联。 方法:我们使用了一项调查中的代表性纵向数据,该调查旨在评估德国北莱茵 - 威斯特法伦州80岁及以上人群的生活质量和主观幸福感。随访时长约为2年。样本包括社区居住者和机构居住者,分析共纳入943个观察对象。参与者的平均年龄为86.0岁(标准差:4.0岁)。通过广泛使用的筛查工具DemTect评估可能的痴呆症。使用常见的收入和财富类别来量化这些变量。 结果:在对社会人口统计学和健康变量进行调整后,逻辑随机效应回归显示,财富越多,患可能痴呆症的可能性越低(与最低财富四分位数相比,第二低财富四分位数:比值比:0.23,95%置信区间:0.07 - 0.76;第二高财富四分位数:比值比:0.05,95%置信区间:0.01 - 0.31;最高财富四分位数:比值比:0.12,95%置信区间:0.02 - 0.91)。相比之下,收入与可能患痴呆症的可能性没有显著关联。 结论:我们的研究表明了财富与痴呆症之间的联系。这些知识可以丰富该领域内关于贫困和不平等的研究。更具体地说,我们的研究结果支持了旨在通过减少经济不平等和改善收入分配来减轻晚年痴呆症负担的循证政策。

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本文引用的文献

[1]
Socioeconomic Status and Risks of Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of 39 Prospective Studies.

J Prev Alzheimers Dis. 2023

[2]
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Alzheimers Dement. 2023-7

[3]
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Sci Rep. 2023-1-3

[4]
Socioeconomic Inequalities in Cognitive Functioning Only to a Small Extent Attributable to Modifiable Health and Lifestyle Factors in Individuals Without Dementia.

J Alzheimers Dis. 2022

[5]
Frequency and correlates of mild cognitive impairment and dementia among the oldest old - Evidence from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)".

Arch Gerontol Geriatr. 2023-1

[6]
Income, wealth, and Black-White disparities in cognition.

Soc Sci Med. 2022-10

[7]
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Arch Gerontol Geriatr. 2022

[8]
Social class and the risk of dementia: A systematic review and meta-analysis of the prospective longitudinal studies.

Scand J Public Health. 2023-12

[9]
Associations of Social Isolation and Loneliness With Later Dementia.

Neurology. 2022-7-11

[10]
Dementia in a Hearing-impaired Population According to Hearing Aid Use: A Nationwide Population-based Study in Korea.

Ear Hear.

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