Socioeconomic Status During Lifetime and Cognitive Impairment No-Dementia in Late Life: The Population-Based Aging in the Chianti Area (InCHIANTI) Study
2011 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, Vol. 24, no 3, 559-568 p.Article in journal (Refereed) Published
Thousand and twelve dementia-free elderly (60-98 years old) enrolled in the InChianti Study (Italy) were evaluated at baseline (1998-2000) and at 3-year follow-up (2001-2003) with the aim of analyzing the association of lifetime socioeconomic status (SES) with prevalent and incident cognitive impairment no-dementia (CIND). SES was defined from information on formal education, longest held occupation, and financial conditions through life. CIND was defined as age-adjusted Mini-Mental State Examination score one standard deviation below the baseline mean score of participants without dementia. Logistic regression and Cox proportional-hazards models were used to estimate the association of SES with CIND. Demographics, occupation characteristics (i.e., job stress and physical demand), cardiovascular diseases, diabetes, apolipoprotein E (APOE) genotype, smoking, alcohol consumption, depressive symptoms, and C-reactive protein were considered potential confounders. Prevalence of CIND was 17.7%. In the fully adjusted model, low education (OR = 2.1; 95% confidence intervals, CI = 1.4 to 3.2) was associated with prevalent CIND. Incidence rate of CIND was 66.0 per 1000 person-years. Low education (HR = 1.7; 95% CI = 1.04 to 2.6) and manual occupation (HR = 1.9; 95% CI = 1.0 to 3.6) were associated with incident CIND. Among covariates, high job-related physical demand was associated with both prevalent and incident CIND (OR = 1.6; 95% CI = 1.1 to 2.4 and HR = 1.5; 95% CI = 1.0 to 2.3). After stratification for education, manual occupation was still associated with CIND among participants with high education (HR = 2.2; 95% CI = 1.2 to 4.3 versus HR = 1.4; 95% CI = 0.2 to 10.4 among those with low education). Proxy markers of lifetime SES (low education, manual occupation and high physical demand) are cross-sectional correlates of CIND and predict incident CIND over a three-year follow-up.
Place, publisher, year, edition, pages
2011. Vol. 24, no 3, 559-568 p.
Cognitive impairment no-dementia, epidemiology, education, finances, occupation, socioeconomic status
IdentifiersURN: urn:nbn:se:su:diva-66632DOI: 10.3233/JAD-2011-101863ISI: 000292496900013OAI: oai:DiVA.org:su-66632DiVA: diva2:468591
authorCount :42011-12-212011-12-202013-01-07Bibliographically approved