Life-course socioeconomic conditions and cognitive performance in older adults: a cross-cohort comparison

Schrempft, Stephanie; Trofimova, Olga; Künzi, Morgane; Draganski, Bogdan; Kliegel, Matthias; Stringhini, Silvia · 2022 · OpenAlex-citations

DOI: 10.1080/13607863.2022.2084511

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Summary

This study investigates the relationship between life-course socioeconomic conditions and cognitive performance in older adults, addressing inconsistencies in prior research regarding how socioeconomic disadvantage affects cognitive trajectories. While socioeconomic disadvantage is consistently linked to lower cognitive levels in old age, findings regarding its impact on cognitive decline have been mixed. The authors aimed to clarify these associations by examining multiple cognitive domains and social mobility trajectories across two independent Swiss cohorts, thereby testing the generalizability of results and the specific effects of childhood versus adulthood socioeconomic status. The analysis utilized data from two population-based cohorts: CoLaus|PsyCoLaus (N = 1,210, mean age 72) and Vivre/Leben/Vivere (VLV) (N = 993, mean age 75). Cognitive performance was assessed at two time points, six years apart, covering verbal fluency, processing speed, cognitive flexibility, memory, and global cognition. Socioeconomic conditions were measured across the life course, including father’s occupation, parental education, own education, occupation, household income, and social mobility trajectories (e.g., stable-low, upward mobility). Statistical models adjusted for covariates such as health behaviors, comorbidities, and depressive symptoms. Associations were examined within each cohort and using pooled data for domains measured similarly across both groups. Results indicated that socioeconomic disadvantage predicted lower levels of cognitive performance across multiple domains, including processing speed, verbal fluency, and memory. These associations followed a dose-response pattern and persisted after adjusting for health behaviors and comorbidities. Individuals experiencing a stable-low socioeconomic trajectory performed significantly worse than those with upward social mobility or stable-high trajectories. For instance, in pooled analyses, those with stable-low trajectories had poorer verbal fluency and memory performance and higher odds of cognitive impairment compared to those with stable-high trajectories. Conversely, associations between socioeconomic disadvantage and longitudinal cognitive decline were less consistent. While some links were observed for inhibitory control and verbal fluency, many did not remain significant after correcting for multiple testing. Educational level emerged as the most consistent predictor of cognitive performance levels. The study concludes that life-course socioeconomic conditions, particularly educational attainment and social mobility, are strong predictors of the level of cognitive performance in older adults across various domains. However, their influence on the rate of cognitive decline is weaker and less consistent. These findings support cognitive reserve theories, suggesting that enriched socioeconomic environments help maintain cognitive function levels, though they may not necessarily slow the rate of age-related decline. The consistency of results across two distinct cohorts underscores the robustness of these associations, highlighting the importance of considering life-course socioeconomic exposures in understanding cognitive aging.

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• cognitive impairment