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Life-course socioeconomic position and incidence of dementia and cognitive impairment without dementia in older Mexican Americans: results from the Sacramento area Latino study on aging

TitleLife-course socioeconomic position and incidence of dementia and cognitive impairment without dementia in older Mexican Americans: results from the Sacramento area Latino study on aging
Publication TypeJournal Article
Year of Publication2011
AuthorsA. Hazzouri, ZAl, Haan, MN, Kalbfleisch, JD, Galea, S, Lisabeth, LD, Aiello, AE
JournalAm J EpidemiolAm J Epidemiol
Volume173
Pagination1148-58
Date PublishedMay 15
ISBN Number1476-6256 (Electronic)<br/>0002-9262 (Linking)
Accession Number21430188
KeywordsAge Factors, Aged, Aged, 80 and Over, California/epidemiology, Cognition Disorders/economics/ epidemiology/etiology, Cohort Studies, Confidence Intervals, Dementia/economics/ epidemiology/etiology, Female, Humans, Incidence, Male, Mexican Americans/psychology/ statistics & numerical data, Middle Aged, Poverty/psychology/statistics & numerical data, Proportional Hazards Models, Risk Factors, Socioeconomic Factors, Survival Analysis
AbstractThere have been few investigations of the link between changes in life-course socioeconomic position (SEP) and cognitive decline or incidence of dementia. The authors examined the impact of changes in life-course SEP on incidence of dementia and cognitive impairment but not dementia (CIND) over a decade of follow-up. Participants of Mexican origin (n = 1,789) were members of the Sacramento Area Latino Study on Aging cohort. Incidence of dementia/CIND was ascertained by using standard diagnostic criteria. SEP indicators at 3 life stages (childhood, adulthood, and midlife) were used to derive a measure of cumulative SEP (range, 0 to 8) and SEP mobility. Nearly 24% of the sample maintained a low SEP throughout life. Hazard ratios and 95% confidence intervals were computed from Cox proportional hazards regression models. In fully adjusted models, participants with a continuously high SEP had lower hazard ratios for dementia/CIND compared with those with a continuously low SEP at all 3 life stages (hazard ratio = 0.49, 95% confidence interval: 0.24, 0.98; P = 0.04). In age-adjusted models, participants experienced a 16% greater hazard of dementia/CIND with every 1-unit increase in cumulative SEP disadvantage across the life course (hazard ratio = 1.16, 95% confidence interval: 1.01, 1.33; P = 0.04). Early exposures to social disadvantage may increase the risk of late-life dementia.