Socioeconomic Status Affects Cognition and Dementia
At the Alzheimer Association International Conference 2022 (AAIC2022) in San Diego, CA and online, multiple studies showing the impact socioeconomic status and other social determinants of health on cognitive health, dementia, and Alzheimer disease were presented.
Perceived neighborhood environment and access to resources was shown to play a role in cognitive health in a study by Anthony Longoria, MS, clinical psychology doctoral candidate at
University of Texas Southwestern. Lower quality of neighborhood resources, poorer access to food, heating, and medical care, as well as exposure to violence correlated with lower scores on the Montreal Cognitive Assessment (MoCA) in Black and Hispanic participants compared with white participants.
Correlations with white matter volume (WMV) and hyperintensities (WMH) were also observed. Lower income and educational attainment were associated with higher WMH in all participants, and lower trust, access to health care, income, and education were significantly associated with lower cerebral WMV. Black women with higher exposure to violence had higher WMH and Hispanic men with lower levels of trust had higher WMV. Among white women, lower access to health care was associated with lower WMV.
“This is important given that minority groups disproportionately experience economic adversity and neighborhood disadvantage, in addition to being more likely to be diagnosed with dementia and receive less timely care,” said Longoria.
Scientists and policymakers should emphasize improving neighborhood resources — including safety, access to high-quality food, clean outdoor spaces and health care — when developing public health policies to help reduce community risk of Alzheimer’s and related dementias,” said Longoria.
A study from the United Kingdom (UK) evaluated genetic risk for developing dementia and covariants of income, wealth, employment rates, car and home ownership, and area-level socioeconomic variation. Data from 196,368 participants’ records in the UK Biobank whose genetic risk for developing dementia was assessed through risk scores. showed individual and area-level socioeconomic deprivation contribute to risk of dementia.
The impact of area-level discrimination was more severe among those who also had moderate-to-high genetic risk for AD. Analyses with neuroimaging biomarkers showed increased burden of white-matter lesions among those with socioeconomic deprivation.
Social determinants of health also have intergenerational effects. Higher socioeconomic status of a person's parents is associated with reduced impact of AD pathology later in life.
In a study from Jennifer Manly, PhD, professor of neuropsychology at Columbia University Irving Medical Center, and colleagues, parents' years of education was associated with reduced impact of the AD biomarker plasma phosphorylated tau-181 (a marker of brain aging and Alzheimer’s disease) on memory, language, and executive function over the course of individual's lifespan.
“Evidence from our multiethnic, intergenerational study suggests that early life socioeconomic conditions may promote cognitive reserve against Alzheimer’s-related brain changes,” said Manly. “These data show how structural and policy-driven investments, such as access to high quality education, have generational implications. Interventions that reduce childhood poverty could narrow Alzheimer’s-related disparities.”