个人社会经济地位、邻里劣势和认知老化:对 CLSA 的纵向分析。

IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Journal of the American Geriatrics Society Pub Date : 2024-08-23 DOI:10.1111/jgs.19155
John R. Best PhD
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摘要

背景:造成中晚年认知能力下降率差异的因素可能有很多,其中包括个人和邻里社会经济因素。本研究探讨了个人社会经济因素(即收入和财富)是否在一定程度上通过邻里层面的社会和物质劣势与认知能力下降相关联:本研究利用加拿大老龄化纵向研究(CLSA)的三波数据收集,纳入了基线年龄在 45 岁至 85 岁之间的 51,338 名参与者(51% 为女性)。个人社会经济地位(SES)通过家庭年收入以及储蓄和投资的现值进行评估。邻里劣势通过基于地区的物质和社会贫困指数来衡量。在每个波次中,均使用言语流畅度、思维交替和延迟单词回忆对认知能力进行测量。我们构建了包含直接和间接途径的潜在变化得分模型,以估算个人社会经济地位通过地区层面的不利条件对认知变化的间接影响。根据年龄组(45-64 岁;65-74 岁;或 75 岁以上)构建了多组模型,以便在不同年龄段得出不同的估计结果:在 45-64 岁的人群中,收入和财富对初始认知水平和因物质条件不利而导致的认知能力下降率有间接影响(标准化间接影响 = 0.01,P 0.05),而在 75 岁以上的人群中,没有观察到间接影响(P > 0.05)。在所有年龄组中,财富和收入对认知能力都有直接影响,与邻里劣势无关(p 结论:在所有年龄组中,财富和收入对认知能力都有直接影响,与邻里劣势无关):在中年人中,个人更高的社会经济地位可能会缓解认知能力的下降,部分原因是个人可以生活在物质和社会条件更优越的社区。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Individual socioeconomic status, neighborhood disadvantage, and cognitive aging: A longitudinal analysis of the CLSA

Background

There are likely many contributors to variation in the rate of cognitive decline in middle and late adulthood, including individual and neighborhood socio-economic factors. This study examines whether individual socio-economic factors, namely income and wealth, correlate with cognitive decline, in part, through neighborhood-level social and material disadvantage.

Methods

Using the three waves of data collection from the Canadian Longitudinal Study on Aging (CLSA), this study included 51,338 participants between the age of 45 and 85 years at baseline (51% female). Individual socio-economic status (SES) was assessed by annual household income and by the current value of savings and investments. Neighborhood disadvantage was measured by area-based material and social deprivation indices. Cognition was measured at each wave using verbal fluency, mental alternations, and delayed word recall. Latent change score models, incorporating direct and indirect pathways, were constructed to estimate the indirect effect of individual SES on cognitive change through area-level disadvantage. Multi-group models were constructed on the basis of age-group (45–64 years; 65–74 years; or 75+ years) to allow for varying estimates across age.

Results

Among 45–64-year-olds, income and wealth had indirect effects on initial cognitive level and on rate of cognitive decline through material disadvantage (standardized indirect effects = 0.01, p < 0.001), but only wealth had an indirect effect through social disadvantage (p = 0.019). Among 65-74-year-olds, income and wealth had indirect effects on initial cognitive level (p < 0.01) but not on rate of cognitive decline (p > 0.05), and among 75+ year-olds, no indirect effects were observed (p > 0.05). Wealth and income had direct effects, independent of neighborhood disadvantage, on cognition in all age groups (p < 0.05).

Conclusions

Among middle-aged adults, greater individual SES may mitigate cognitive decline, in part, by allowing individuals to live in more materially and socially advantaged neighborhoods.

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来源期刊
CiteScore
10.00
自引率
6.30%
发文量
504
审稿时长
3-6 weeks
期刊介绍: Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.
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