Chi Chiao1, Amanda Botticello2, Jong-Ling Fuh3. 1. Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan cchiao@ym.edu.tw. 2. Kessler Medical Rehabilitation Research and Education Center and Department of Physical Medicine & Rehabilitation, UMDNJ-New Jersey Medical School, Piscataway, NJ, USA. 3. The Neurological Institute, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Abstract
BACKGROUND: Declines in late-life cognitive functioning differ greatly between socio-economic status (SES) groups, but little is known about whether these effects are related to child and adult SES versus SES effects that accumulate over the individual's life course. METHODS: An 18-year longitudinal national sample of older adults from Taiwan (n=2944) was used to estimate the effect of socio-economic disadvantage over the individual's life course on cognitive functioning during late life. Cognitive functioning was assessed using the brief Short Portable Mental Status Questionnaire scale. Life-course socio-economic disadvantage, as accrued during childhood and adulthood, included measures of paternal education and occupation and participant's education and occupation. RESULTS: Multivariate analyses using various mixed-effects models showed that the effects of childhood SES could be largely explained by adult SES and that disadvantageous SES in adulthood further exacerbated declines in late-life cognitive functioning (β=-0.02; p<0.001), even controlling for aging, practice and other covariates. Possible factors that are associated with life-course socio-economic disadvantage and late-life cognitive decline included household income and perception of economic strain. CONCLUSIONS: The results suggest a critical role for life-course socio-economic disadvantage in late-life cognitive decline and that this may be manifested via the inequitable distribution of socio-economic resources over the individual's life course.
BACKGROUND:Declines in late-life cognitive functioning differ greatly between socio-economic status (SES) groups, but little is known about whether these effects are related to child and adult SES versus SES effects that accumulate over the individual's life course. METHODS: An 18-year longitudinal national sample of older adults from Taiwan (n=2944) was used to estimate the effect of socio-economic disadvantage over the individual's life course on cognitive functioning during late life. Cognitive functioning was assessed using the brief Short Portable Mental Status Questionnaire scale. Life-course socio-economic disadvantage, as accrued during childhood and adulthood, included measures of paternal education and occupation and participant's education and occupation. RESULTS: Multivariate analyses using various mixed-effects models showed that the effects of childhood SES could be largely explained by adult SES and that disadvantageous SES in adulthood further exacerbated declines in late-life cognitive functioning (β=-0.02; p<0.001), even controlling for aging, practice and other covariates. Possible factors that are associated with life-course socio-economic disadvantage and late-life cognitive decline included household income and perception of economic strain. CONCLUSIONS: The results suggest a critical role for life-course socio-economic disadvantage in late-life cognitive decline and that this may be manifested via the inequitable distribution of socio-economic resources over the individual's life course.