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October 23, 2018; 91 (17) Article

Socioeconomic position in childhood and cognitive aging in Europe

Pavla Cermakova, Tomas Formanek, Anna Kagstrom, Petr Winkler
First published September 26, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006390
Pavla Cermakova
From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Tomas Formanek
From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Anna Kagstrom
From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Petr Winkler
From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Socioeconomic position in childhood and cognitive aging in Europe
Pavla Cermakova, Tomas Formanek, Anna Kagstrom, Petr Winkler
Neurology Oct 2018, 91 (17) e1602-e1610; DOI: 10.1212/WNL.0000000000006390

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Abstract

Objectives We aimed to investigate whether socioeconomic position (SEP) in childhood has an effect on the level of cognitive performance and the rate of cognitive decline in older adults.

Methods We performed a prospective cohort study of individuals enrolled in a multicenter population-based study, SHARE (Survey of Health, Ageing and Retirement in Europe). Interviews were conducted in 6 waves at approximately 2-year intervals and included examinations of cognitive performance (memory, verbal fluency, delayed recall) and measurements of childhood SEP (participants' household characteristics at the age of 10 years). We estimated the associations of SEP with the level of cognitive performance using linear regression and the relation to the rate of cognitive decline with mixed-effects models.

Results This study included 20,244 participants from 16 European countries (median age at baseline 71 years, 54% women). Adverse childhood SEP was associated with a lower level of baseline cognitive performance. This association was attenuated after adjustment for clinical and social risk factors but remained statistically significant. Childhood SEP was not related to the rate of cognitive decline.

Conclusions Variation in childhood SEP helps to explain differences in cognitive performance between older people, but not the rate of decline from their previous level of cognition. Strategies to protect cognitive aging should be applied early in life.

Glossary

BRC=
brain reserve capacity;
CI=
confidence interval;
HICs=
high-income countries;
LMICs=
low- and middle-income countries;
SEP=
socioeconomic position;
SHARE=
Survey of Health, Ageing and Retirement in Europe

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received February 17, 2018.
  • Accepted in final form July 17, 2018.
  • © 2018 American Academy of Neurology
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