Summary: A new data analysis study of people born between 1902 and 1943 reveals 20% of the most deprived adults were 50% more likely to develop dementia.
Older adults in England with fewer financial resources are more likely to develop dementia, according to new UCL research.
Researchers analysed data from over 6000 adults born between 1902 and 1943 and found that the 20% most deprived adults were 50% more likely to develop dementia than the 20% least deprived adults.
The study, published today in JAMA Psychiatry, is the first of its kind to determine which socioeconomic factors influence dementia and found limited wealth in late life is associated with increased risk of dementia, independent of education.
“Dementia is a progressive neurodegenerative condition with devastating consequences to individuals, their families and governments around the world. Our efforts are unified in identifying the risk factors associated with a delay in the onset of dementia onset or a slower progression,” said lead author, Dr Dorina Cadar (UCL Institute of Epidemiology & Health). “Our findings demonstrate that socioeconomic determinants influence dementia incidence, suggesting a higher risk for individuals with fewer financial resources.”
Researchers analysed data from the English Longitudinal Study of Ageing (ELSA), a prospective cohort study that is representative of the English population. Two independent groups were derived using a median split (born between 1902-1925 and 1926-1943) to investigate if there were differences over time.
The authors found that socioeconomic inequalities were more prominent for individuals born in later years (from 1926 onwards) than in those born earlier in the 20th century.
Professor Andrew Steptoe (UCL Institute of Epidemiology & Health), senior author of the study, explained: “Our study confirms that the risk of dementia is reduced among well-off older people compared with those who have fewer economic resources. Many factors could be involved. Differences in healthy lifestyle and medical risk factors are relevant. It may also be that better off people have greater social and cultural opportunities that allow them to remain actively engaged with the world.”
Dr Cadar added: “The research demonstrates the importance of socioeconomic influences on dementia incidence. We hope our findings help inform public health strategies for dementia prevention evidencing why socioeconomic gaps should be targeted to reduce health disparities and enhance engagement in socio-cultural activities that ultimately contribute to a higher mental resilience or cognitive reserve.”
Source: Rowan Walker – UCL
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Image Source: NeuroscienceNews.com image is adapted from the UCL news release.
Original Research: Open access research for “Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England: Evidence From a 12-Year Follow-up in the English Longitudinal Study of Ageing” by Dorina Cadar, PhD; Camille Lassale, PhD; Hilary Davies, PhD; David J. Llewellyn, PhD; G. David Batty, DSc; and Andrew Steptoe, DSc in JAMA Psychiatry. Published May 15 2018.
Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England: Evidence From a 12-Year Follow-up in the English Longitudinal Study of Ageing
Importance Lower educational attainment is associated with a higher risk of dementia. However, less clear is the extent to which other socioeconomic markers contribute to dementia risk.
Objective To examine the relationship of education, wealth, and area-based deprivation with the incidence of dementia over the last decade in England and investigate differences between people born in different periods.
Design, Setting, and Participants Data from the English Longitudinal Study of Ageing, a prospective cohort study that is representative of the English population, were used to investigate the associations between markers of socioeconomic status (wealth quintiles and the index of multiple deprivation) and dementia incidence. To investigate outcomes associated with age cohorts, 2 independent groups were derived using a median split (born between 1902-1925 and 1926-1943) .
Main Outcomes and Measures Dementia as determined by physician diagnosis and the Informant Questionnaire on Cognitive Decline in the Elderly.
Results A total of 6220 individuals aged 65 years and older enrolled in the study (median [interquartile range] age at baseline, 73.2 [68.1-78.3] years; 3410 [54.8%] female). Of these, 463 individuals (7.4%) had new cases of dementia ascertained in the 12 years between 2002-2003 and 2014-2015. The hazard of developing dementia was 1.68 times higher (hazard ratio [HR] = 1.68 [95% CI, 1.05-2.86]) for those in the lowest wealth quintile compared with those in the highest quintile, independent of education, index of multiple deprivation, and health indicators. Higher hazards were also observed for those in the second-highest quintile of index of multiple deprivation (HR = 1.62 [95% CI, 1.06-2.46]) compared with those in the lowest (least deprived) quintile.
Conclusions and Relevance In an English nationally representative sample, the incidence of dementia appeared to be socioeconomically patterned primarily by the level of wealth. This association was somewhat stronger for participants born in later years.