TY - JOUR
T1 - Socioeconomic position, modifiable dementia risk and cognitive decline
T2 - results of 12-year Maastricht Aging Study
AU - Heger, Irene
AU - van Boxtel, Martin
AU - Deckers, Kay
AU - Bosma, Hans
AU - Verhey, Frans
AU - Köhler, Sebastian
PY - 2023/10/31
Y1 - 2023/10/31
N2 - OBJECTIVES: This study investigated whether the association between modifiable dementia risk and rate of cognitive decline differs across socioeconomic status (SES) strata. DESIGN, SETTING AND PARTICIPANTS: Data were used from Maastricht Aging Study, a prospective cohort study with a 12-year follow-up. The baseline sample consisted of 1023 adults over 40 years old. MEASUREMENTS: The "LIfestyle for BRAin health" (LIBRA) index was used to assess modifiable dementia risk. Cognitive performance was assessed at baseline, 6 and 12 years, and measured in the domains of information processing speed, executive functioning and verbal memory function. An SES score was calculated from equivalent income and educational level (tertiles). Linear mixed models were used to study the association between LIBRA, SES and their interaction on the rate of cognitive decline. RESULTS: Participants in the lowest SES tertile displayed more decline in information processing speed (vs. middle SES: X = 7.08, = 0.029; vs. high SES: X = 9.49, = 0.009) and verbal memory (vs. middle SES: X = 9.28, < 0.001; vs. high SES: X = 16.68, < 0.001) over 6 years compared to their middle- and high-SES counterparts. Higher (unhealthier) LIBRA scores were associated with more decline in information processing speed (X = 12.66, = 0.002) over 12 years and verbal memory (X = 4.63, = 0.032) over 6 years. No consistent effect modification by SES on the association between LIBRA and cognition was found. CONCLUSIONS: Results suggest that lifestyle is an important determinant of cognitive decline across SES groups. Yet, people with low SES had a more unfavorable modifiable risk score suggesting more potential for lifestyle-based interventions.
AB - OBJECTIVES: This study investigated whether the association between modifiable dementia risk and rate of cognitive decline differs across socioeconomic status (SES) strata. DESIGN, SETTING AND PARTICIPANTS: Data were used from Maastricht Aging Study, a prospective cohort study with a 12-year follow-up. The baseline sample consisted of 1023 adults over 40 years old. MEASUREMENTS: The "LIfestyle for BRAin health" (LIBRA) index was used to assess modifiable dementia risk. Cognitive performance was assessed at baseline, 6 and 12 years, and measured in the domains of information processing speed, executive functioning and verbal memory function. An SES score was calculated from equivalent income and educational level (tertiles). Linear mixed models were used to study the association between LIBRA, SES and their interaction on the rate of cognitive decline. RESULTS: Participants in the lowest SES tertile displayed more decline in information processing speed (vs. middle SES: X = 7.08, = 0.029; vs. high SES: X = 9.49, = 0.009) and verbal memory (vs. middle SES: X = 9.28, < 0.001; vs. high SES: X = 16.68, < 0.001) over 6 years compared to their middle- and high-SES counterparts. Higher (unhealthier) LIBRA scores were associated with more decline in information processing speed (X = 12.66, = 0.002) over 12 years and verbal memory (X = 4.63, = 0.032) over 6 years. No consistent effect modification by SES on the association between LIBRA and cognition was found. CONCLUSIONS: Results suggest that lifestyle is an important determinant of cognitive decline across SES groups. Yet, people with low SES had a more unfavorable modifiable risk score suggesting more potential for lifestyle-based interventions.
KW - cognitive testing
KW - dementia
KW - education
KW - health aging
KW - risk factors
U2 - 10.1017/S1041610223000819
DO - 10.1017/S1041610223000819
M3 - Article
SN - 1041-6102
SP - 1
EP - 13
JO - International Psychogeriatrics
JF - International Psychogeriatrics
ER -