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Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England: Evidence From a 12-Year Follow-up in the English Longitudinal Study of Ageing
Open accessAbstract
Importance: Lower educational attainment is associated with a higher risk of dementia. However, less clear is the extent to which other socioeconomic markers contribute to dementia risk. Objective: To examine the relationship of education, wealth, and area-based deprivation with the incidence of dementia over the last decade in England and investigate differences between people born in different periods. Design, Setting, and Participants: Data from the English Longitudinal Study of Ageing, a prospective cohort study that is representative of the English population, were used to investigate the associations between markers of socioeconomic status (wealth quintiles and the index of multiple deprivation) and dementia incidence. To investigate outcomes associated with age cohorts, 2 independent groups were derived using a median split (born between 1902-1925 and 1926-1943). Main Outcomes and Measures: Dementia as determined by physician diagnosis and the Informant Questionnaire on Cognitive Decline in the Elderly. Results: A total of 6220 individuals aged 65 years and older enrolled in the study (median [interquartile range] age at baseline, 73.2 [68.1-78.3] years; 3410 [54.8%] female). Of these, 463 individuals (7.4%) had new cases of dementia ascertained in the 12 years between 2002-2003 and 2014-2015. In the cohort born between 1926 and 1943, the hazard of developing dementia was 1.68 times higher (hazard ratio [HR] = 1.68 [95% CI, 1.05-2.86]) for those in the lowest wealth quintile compared with those in the highest quintile, independent of education, index of multiple deprivation, and health indicators. Higher hazards were also observed for those in the second-highest quintile of index of multiple deprivation (HR = 1.62 [95% CI, 1.06-2.46]) compared with those in the lowest (least deprived) quintile. Conclusions and Relevance: In an English nationally representative sample, the incidence of dementia appeared to be socioeconomically patterned primarily by the level of wealth. This association was somewhat stronger for participants born in later years.
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“research shows dementia risk to be associated with lower socio-economic status, independently of education status118,119.”
From Genetic meta-analysis of diagnosed Alzheimer’s disease identifies new risk loci and implicates Aβ, tau, immunity and lipid processing (2019) · cites this paper as [118]
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Metadata
- Authors
- Cadar, D., Lassale, C., Davies, H., Llewellyn, D. J., Batty, G. D., & Steptoe, A.
- Affiliations
- University College London (GB)
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
- University of Exeter (GB)
- Corresponding author
- Cadar, Dorina
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2018-07-01
- Volume
- 75
- Issue
- 7
- Pages
- 723
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC6145673
- OpenAlex
- W2803752526
- Cited by
- 245
- References
- 44
- Citations by year
- 2026: 29 · 2025: 28 · 2024: 51 · 2023: 39 · 2022: 28 · 2021: 23 · 2020: 26 · 2019: 16 · 2018: 5
- FWCI
- 13.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- JAMA Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
- Funders
- National Institute on Aging (R01AG017644)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Keywords
- dementia incidence, socioeconomic status, educational attainment, wealth, area deprivation, Index of Multiple Deprivation, birth cohort differences, older adults, cognitive decline
- MeSH terms
- Economic Status, Aged, Aged, 80 and over, Dementia, Educational Status, England, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Socioeconomic Factors, Cohort Studies, Incidence, Proportional Hazards Models
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