Socio-economic factors such as education, occupation and wealth influence the likelihood of developing cognitive impairment or dementia later in life and whether someone is likely to recover, according to a new study led by UCL researchers.
The research, published in Scientific reportsfollowed 8,442 adults aged 50 and over in England for 10 years from 2008/09 to 2018/19, to investigate how socio-economic factors at the start of the study were associated with changes in cognitive status.
The researchers monitored how these people moved between different states: healthy, mild cognitive impairment and dementia. They also considered the possibility of reversals, where individuals improved from mild cognitive impairment to a healthy state.
Information on socio-economic factors was collected via a self-administered questionnaire. Cognitive impairment was assessed using a mix of sources, including participants’ reports of a doctor’s diagnosis, cognitive test results, and their own reports of symptoms and complaints, providing a complete picture of each participant’s cognitive health. In addition to these aspects, the study also took into account demographic factors, such as age, gender and marital status.
By estimating the time spent in each cognitive state and the likelihood of transitions to neurocognitive disorders such as cognitive impairment and dementia, the researchers were able to gain a comprehensive understanding of how socioeconomic factors influence the progression of a person’s disorder, as well as the its duration. spent in each cognitive state over time.
The team found that people from socio-economically advantaged backgrounds – especially those with post-secondary education (such as university or college), managerial or professional occupations, and those in the wealthiest third of the population – were less likely to move from a healthy cognitive state to mild cognitive impairment, or from mild cognitive impairment to dementia compared with those with a primary school education (not higher than secondary school), working in manual or routine occupations, and in the most socio-economically disadvantaged third of the population.
For example, having a post-secondary education level was associated with a 43% lower likelihood of moving from a healthy cognitive state to mild cognitive impairment.
Meanwhile, being in the richest third of the population was associated with a 26% lower chance of transitioning from mild cognitive impairment to dementia.
Notably, these privileged individuals were also more likely to recover from mild cognitive impairment and return to a healthy cognitive state, with wealthy individuals 56% more likely and those with post-secondary education or who worked in manual labor 81% were more likely to recover. improve, compared to socio-economically disadvantaged individuals.
Senior author Dr Dorina Cadar (UCL Department of Behavioral Science and Health and Brighton and Sussex Medical School) said: “Our study highlights the crucial role of wealth, education and occupation, not only in reducing the risk of transitioning from mild cognitive impairment to dementia. but also in increasing the chance of reversing cognitive impairment into a healthy cognitive state, which is promising.
This potential recovery is critical for improving quality of life in later years and reducing the long-term burden of cognitive impairment on healthcare systems, families and society as a whole.”
Dr. Dorina Cadar, Department of Behavioral Sciences and Health, University College London
“Our findings highlight the potential protective power of financial stability and access to resources in promoting brain health and cognitive resilience, and underscore the importance of social policies that support mental and cognitive well-being at all income levels.”
The research cannot provide an exact explanation as to why certain socioeconomic factors influence cognitive health. However, the authors believe that there could be several reasons behind their findings.
Lead author and PhD candidate Aswathikutty Gireesh (UCL Epidemiology & Health Care) said: “It is possible that education and intellectually demanding jobs provide more mental stimulation and help build a stronger brain reserve to help protect individuals against cognitive impairment and dementia.
“Additionally, people with higher education, more intellectually demanding jobs and wealth have better access to healthcare and health-promoting resources such as a nutritious diet, exercise and preventive care – all of which can support cognitive health. These agents may also provide opportunities to stabilize or improve cognitive function, especially when cognitive impairment is detected early.”
The researchers hope their findings will open new avenues for further research into how socioeconomic factors, particularly wealth, can protect against early progression to cognitive impairment.
Source:
Magazine reference:
Gireesh, A., et al. (2024) Socioeconomic inequalities associated with the transition to neurocognitive disorders and mortality. Scientific reports. doi.org/10.1038/s41598-024-74125-w.