Health (social science); socioeconomic inequalities; social determinants of health; cognitive functioning; structural brain damage; brain connectivity; early-life socioeconomic status; causal mediation analysis; population health
Abstract :
[en] [en] BACKGROUND: Socioeconomic inequalities in cognitive impairment may partly act through structural brain damage and reduced connectivity. This study investigated the extent to which the association of early-life socioeconomic position (SEP) with later-life cognitive functioning is mediated by later-life SEP, and whether the associations of SEP with later-life cognitive functioning can be explained by structural brain damage and connectivity.
METHODS: We used cross-sectional data from the Dutch population-based Maastricht Study (n = 4,839; mean age 59.2 ± 8.7 years, 49.8% women). Early-life SEP was assessed by self-reported poverty during childhood and parental education. Later-life SEP included education, occupation, and current household income. Participants underwent cognitive testing and 3-T magnetic resonance imaging to measure volumes of white matter hyperintensities, grey matter, white matter, cerebrospinal fluid, and structural connectivity. Multiple linear regression analyses tested the associations between SEP, markers of structural brain damage and connectivity, and cognitive functioning. Mediation was tested using structural equation modeling.
RESULTS: Although there were direct associations between both indicators of SEP and later-life cognitive functioning, a large part of the association between early-life SEP and later-life cognitive functioning was explained by later-life SEP (72.2%). The extent to which structural brain damage or connectivity acted as mediators between SEP and cognitive functioning was small (up to 5.9%).
CONCLUSIONS: We observed substantial SEP differences in later-life cognitive functioning. Associations of structural brain damage and connectivity with cognitive functioning were relatively small, and only marginally explained the SEP gradients in cognitive functioning.
Research center :
Integrative Research Unit: Social and Individual Development (INSIDE) > PEARL Institute for Research on Socio-Economic Inequality (IRSEI)
Disciplines :
Public health, health care sciences & services Neurology Sociology & social sciences
Author, co-author :
GERAETS, Anouk ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > Department of Social Sciences (DSOC) > Socio-Economic Inequality
Schram, Miranda T ; Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands, Department of Internal Medicine, Maastricht, The Netherlands, Heart and Vascular Centre, Maastricht, The Netherlands, School for Mental Health and Neuroscience (MHeNs), Maastricht, The Netherlands, School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
Jansen, Jacobus F A ; School for Mental Health and Neuroscience (MHeNs), Maastricht, The Netherlands, Department of Radiology, Maastricht, The Netherlands
Köhler, Sebastian; Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands, School for Mental Health and Neuroscience (MHeNs), Maastricht, The Netherlands, Alzheimer Centrum Limburg, Maastricht, The Netherlands
van Boxtel, Martin P J; Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands, School for Mental Health and Neuroscience (MHeNs), Maastricht, The Netherlands, Alzheimer Centrum Limburg, Maastricht, The Netherlands
Eussen, Simone J P M ; School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands, Department of Epidemiology, Maastricht, The Netherlands, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
Koster, Annemarie ; Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands, Department of Social Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
Stehouwer, Coen D A; Department of Internal Medicine, Maastricht, The Netherlands, School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
Bosma, Hans ; Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands, Department of Social Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
LEIST, Anja ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > Department of Social Sciences (DSOC) > Socio-Economic Inequality
External co-authors :
yes
Language :
English
Title :
The associations of socioeconomic position with structural brain damage and connectivity and cognitive functioning: The Maastricht Study.
Publication date :
10 July 2024
Journal title :
Social Science and Medicine
ISSN :
0277-9536
eISSN :
1873-5347
Publisher :
Elsevier Ltd, England
Volume :
355
Pages :
117111
Peer reviewed :
Peer Reviewed verified by ORBi
Development Goals :
3. Good health and well-being 10. Reduced inequalities
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