Multiple Components of Socioeconomic Deprivation Contribute to Cognitive Decline

Several studies presented at the Alzheimer’s Association International Conference (AAIC) 2022, held July 31 to August 4 in San Diego, California focused on the intersection between socioeconomic status and cognition, finding that greater deprivation increased risk for dementia and cognitive decline.

The investigators at the University of Luxembourg in Esch-sur-Alzette evaluated 10-year follow-up data from the UK Biobank (N=196,368) and compared socioeconomic deprivation with genetic risk and brain imaging data. They found that both genetic risk and socioeconomic deprivation were independently associated with dementia risk. Among individuals with high genetic risk and individual-level deprivation, 1.78% (95% CI, 1.50-2.09) developed dementia during follow-up compared with 0.31% (95% CI, 0.20-0.45) among those with low risk for both measures.

In a second study, researchers at the University of Texas Southwestern Medical Center in Dallas evaluated data from the Dallas Heart Study Phase 2. This cohort comprised 3858 participants, 51% of whom were Black and 14% were Hispanic. They found that economic adversity is associated with lower cognitive scores. Among the Black participants, economic adversity accounted for more variance in cognitive scores than education or income, and for Hispanic participants, more variance than income. No such relationships were observed among White participants.

In a study assessing memory among middle-aged adults, investigators at Columbia University Irving Medical Center in New York City sourced data from a longitudinal community-based study of Manhattan residents. Middle-aged adult children (n=1038) of older parents (n=694) were found to have lower delayed recall with higher pTau181 concentrations (β, -0.438; P <.001). The relationship between pTau181 and delayed recall was stronger among participants with lower parental socioeconomic status (β, -0.477; P =.019) than among those with higher parental socioeconomic status (β, -0.291; P <.022), indicating early life socioeconomic status likely has an effect of later life cognition.

To evaluate the effect of salary on memory decline, investigators at Columbia University Mailman School of Public Health in New York City sourced data from the 1992 to 2016 Health and Retirement Study. Memory function among 1913 men and 1890 women measured between 2004 and 2016 was compared with wages earned between 1992 and 2004. Both men and women who had sustained low wages over 10 years in mid-life experienced more rapid memory decline (β, -0.12) compared with individuals who never earned a low wage.

Socioeconomic status can also affect access to nutrition. A study conducted at the University of São Paulo Medical School in Brazil interrogated the effect of consuming ultra-processed foods (UPF) on cognitive performance. The 8160 participants in the ELSA-Brasil study were stratified into quintiles on the basis of how much of their diet comprised UPF. The high-UPF consumers were found to have a poorer executive function (β, -0.007; P =.004) and memory performance (β, -0.004; P =.048) during the 9-year follow-up.

Altogether these data emphasized that the conditions individuals experience throughout their life are all important factors and likely impact brain health.

References:

  1. Klee M, et al. Socioeconomic deprivation, genetics and risk of dementia. In: Proceedings from the Alzheimer’s Association International Conference; July 31-August 4, 2022; San Diego, CA. [Abstract] 66803.
  2. Longoria A, et al. Allostatic load and the influence of economic adversity and neighborhood disadvantage on cognitive function in a multiethnic cohort. In: Proceedings from the Alzheimer’s Association International Conference; July 31-August 4, 2022; San Diego, CA. [Abstract] 68217.
  3. Manly J, et al. Parental SES buffers the effect of plasma pTau181 on memory among non-Latinx White, Latinx, and non-Latinx Black middle-aged adults. In: Proceedings from the Alzheimer’s Association International Conference; July 31-August 4, 2022; San Diego, CA. [Abstract] 66616.
  4. Kezios K, et al. Low hourly wages in middle-age are associated with faster memory decline in older age: evidence from the Health and Retirement Study. In: Proceedings from the Alzheimer’s Association International Conference; July 31-August 4, 2022; San Diego, CA. [Abstract] 61298.
  5. Gonçalves N, et al. Consumption of ultra-processed foods and cognitive decline in the ELSA-Brasil Study: a prospective study. In: Proceedings from the Alzheimer’s Association International Conference; July 31-August 4, 2022; San Diego, CA. [Abstract] 63301.