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November 12, 2019; 93 (20) Article

Relation between 20-year income volatility and brain health in midlife

The CARDIA study

Leslie Grasset, M. Maria Glymour, Tali Elfassy, Samuel L. Swift, Kristine Yaffe, Archana Singh-Manoux, Adina Zeki Al Hazzouri
First published October 2, 2019, DOI: https://doi.org/10.1212/WNL.0000000000008463
Leslie Grasset
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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M. Maria Glymour
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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Tali Elfassy
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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Samuel L. Swift
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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Kristine Yaffe
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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Archana Singh-Manoux
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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Adina Zeki Al Hazzouri
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
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Relation between 20-year income volatility and brain health in midlife
The CARDIA study
Leslie Grasset, M. Maria Glymour, Tali Elfassy, Samuel L. Swift, Kristine Yaffe, Archana Singh-Manoux, Adina Zeki Al Hazzouri
Neurology Nov 2019, 93 (20) e1890-e1899; DOI: 10.1212/WNL.0000000000008463

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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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