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Abstract
Objective Income volatility presents a growing public health threat. To our knowledge, no previous study examined the relationship among income volatility, cognitive function, and brain integrity.
Methods We studied 3,287 participants aged 23–35 years in 1990 from the Coronary Artery Risk Development in Young Adults prospective cohort study. Income volatility data were created using income data collected from 1990 to 2010 and defined as SD of percent change in income and number of income drops ≥25% (categorized as 0, 1, or 2+). In 2010, cognitive tests (n = 3,287) and brain scans (n = 716) were obtained.
Results After covariate adjustment, higher income volatility was associated with worse performance on processing speed (β = −1.09, 95% confidence interval [CI] −1.73 to −0.44) and executive functioning (β = 2.53, 95% CI 0.60–4.50) but not on verbal memory (β = −0.02, 95% CI −0.16 to 0.11). Similarly, additional income drops were associated with worse performance on processing speed and executive functioning. Higher income volatility and more income drops were also associated with worse microstructural integrity of total brain and total white matter. All findings were similar when restricted to those with high education, suggesting reverse causation may not explain these findings.
Conclusion Income volatility over a 20-year period of formative earning years was associated with worse cognitive function and brain integrity in midlife.
Glossary
- BMI=
- body mass index;
- CARDIA=
- Coronary Artery Risk Development in Young Adults study;
- CI=
- confidence interval;
- CVD=
- cardiovascular disease;
- DSST=
- Digit Symbol Substitution Test;
- FA=
- fractional anisotropy;
- HS=
- high school;
- ICV=
- intracranial volume;
- IPCW=
- inverse probability of censoring weights;
- RAVLT=
- Rey Auditory Verbal Learning Test;
- SBP=
- systolic blood pressure;
- SES=
- socioeconomic status
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.
Editorial, page 873
- Received January 18, 2019.
- Accepted in final form June 24, 2019.
- © 2019 American Academy of Neurology
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