Socioeconomic Disparities and Mortality after a Diagnosis of Dementia: Results From a Nationwide Registry Linkage Study
Open accessAbstract
Low socioeconomic status (SES) has been linked to a higher incidence of dementia. Less is known about the association between SES and mortality in persons with dementia. We studied this association in a prospective cohort of 15,558 patients in the Netherlands between 2000 and 2010. SES was measured using disposable household income and divided in tertiles. Overall, there was a negative relationship between SES and mortality in both sexes and both settings of care. For men who visited a day clinic, the 5-year mortality rate was 74% among those in the lowest tertile of SES and 57% among those in the highest; for women, the rates were 60% and 50%, respectively. The differences in median survival times between persons in the lower and upper tertiles of SES were 260 days for men and 300 days for women. For men who were admitted to the hospital, the 5-year mortality rate was 89% among those in the lowest tertile of SES and 86% among those in the highest; for women, the rates were 83% and 77%, respectively. The differences in median survival times between persons in the lower and upper tertiles of SES were 80 days for men and 130 days for women. Among patients who visited a day clinic, for patients in the lowest tertile of SES versus those in the highest, the adjusted hazard ratio was 1.41 (95% confidence interval: 1.26, 1.57); for those admitted to the hospital, it was 1.14 (95% confidence interval: 1.07, 1.20). In summary, lower SES was associated with a higher mortality risk in both men and women with dementia. The results of the present study should raise awareness in clinicians and caregivers about the unfavorable prognosis in the most deprived patients.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Existing research examines the impact of few social, demographic or geographic factors in mortality risk among people living with dementia.
“Existing research examines the impact of few social, demographic or geographic factors in mortality risk among PLWD [1,2,40].”
From The Impact of demographic, socio-economic and geographic factors on mortality risk among people living with dementia in England (2002–2016) (2021) · cites this paper as [1]
There are inequalities in mortality for people living with dementia by various socio-economic and geographic factors.
“There are inequalities in mortality for people living with dementia (PLWD) by various socio-economic and geographic factors [1,2].”
From The Impact of demographic, socio-economic and geographic factors on mortality risk among people living with dementia in England (2002–2016) (2021) · cites this paper as [1]
Cites
Quan, H., Li, B., Couris, C. M., Fushimi, K., Graham, P. J., Hider, P., Januel, J., & Sundararajan, V. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwq433 · Cited by 5,858 · see citing works
Indicators of socioeconomic position (part 1): Figure 1
Galobardes, B., Shaw, M., Lawlor, D. A., Lynch, J. W., & Smith, G. D. (2005) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2004.023531 · Cited by 2,880 · see citing works
Association of socioeconomic position with health behaviors and mortality
Stringhini, S. (2010) · JAMA · doi:10.1001/jama.2010.297 · Cited by 1,065 · see citing works
Health disparities across the lifespan: Meaning, methods, and mechanisms
Adler, N. E., & Stewart, J. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.05337.x · Cited by 729 · see citing works
Dalstra, J., Kunst, A. E., Borrell, C., Breeze, E., Cambois, E., Costa, G., Geurts, J., Lahelma, E. T., Oyen, H. J. V., Rasmussen, N. K., et al. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyh386 · Cited by 594 · see citing works
Berkman, L. F. A. K. (2014) · Oxford University Press eBooks · doi:10.1093/med/9780195377903.001.0001 · Cited by 485 · see citing works
Survival Following a Diagnosis of Alzheimer Disease
Brookmeyer, R., Corrada, M. M., Curriero, F. C., & Kawas, C. H. (2002) · Archives of Neurology · doi:10.1001/archneur.59.11.1764 · Cited by 408 · see citing works
Letenneur, L., Gilleron, V, Commenges, D., Helmer, C., Orgogozo, J. M., & Dartigues, J. F. (1999) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.66.2.177 · Cited by 406 · see citing works
Prince, M., Acosta, D., Ferri, C., Guerra, M., Huang, Y.-Q., Rodriguez, J. L. L., Salas, A., Sosa, A., Williams, J. D., Dewey, M., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60399-7 · Cited by 328 · see citing works
Dewey, M. E., & Saz, P. (2001) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.397 · Cited by 298 · see citing works
Stern, Y., Tang, M. X., Denaro, J., & Mayeux, R. (1995) · Annals of Neurology · doi:10.1002/ana.410370508 · Cited by 252 · see citing works
Qiu, C., Bäckman, L., Winblad, B. G., Agüero‐Torres, H., & Fratiglioni, L. (2001) · Archives of Neurology · doi:10.1001/archneur.58.12.2034 · Cited by 243 · see citing works
Socioeconomic Status and Mortality among the Elderly: Findings from Four US Communities
Bassuk, S. S. (2002) · American Journal of Epidemiology · doi:10.1093/aje/155.6.520 · Cited by 202 · see citing works
Relation between income inequality and mortality: empirical demonstration
Wolfson, M. C. (2000) · Western Journal of Medicine · doi:10.1136/ewjm.172.1.22 · Cited by 185 · see citing works
Scazufca, M., Menezes, P., Vallada, H., Crepaldi, A. L., Pastor-Valero, M., Coutinho, L. M. S., Rienzo, V. D. D., & Almeida, O. (2008) · International Psychogeriatrics · doi:10.1017/s1041610207005625 · Cited by 183 · see citing works
Barriers to healthcare access in a non-elderly urban poor American population
Ahmed, S. M., Lemkau, J. P., Nealeigh, N., & Mann, B. (2001) · Health & Social Care in the Community · doi:10.1046/j.1365-2524.2001.00318.x · Cited by 158 · see citing works
Russ, T. C., Stamatakis, E., Hamer, M., Starr, J. M., Kivimäki, M., & Batty, G. D. (2013) · British Journal of Psychiatry · doi:10.1192/bjp.bp.112.119479 · Cited by 152 · see citing works
Wolfson, M. C., Kaplan, G. A., Lynch, J. W., Ross, N. P., Backlund, E., Gravelle, H. S. E., & Wilkinson, R. G. (1999) · BMJ · doi:10.1136/bmj.319.7215.953 · Cited by 150 · see citing works
The reliability of cause-of-death coding in The Netherlands
Harteloh, P., de Bruin, K., & Kardaun, J. W. P. F. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9445-5 · Cited by 147 · see citing works
Brooker, D. J. R., Fontaine, J. L., Evans, S. C., Bray, J., & Saad, K. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4066 · Cited by 140 · see citing works
SantaCruz, K. S., & Swagerty, D. L. (2001) · PubMed · Cited by 126 · see citing works
Valenzuela, M., Brayne, C., Sachdev, P. S., & Wilcock, G. K. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwq476 · Cited by 123 · see citing works
The Transition From Home to Nursing Home Mortality Among People With Dementia
Aneshensel, C. S., Pearlin, L. I., Levy-Storms, L., & Schuler, R. H. (2000) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/55.3.s152 · Cited by 117 · see citing works
Dementia and Life Expectancy: What Do We Know?
Lee, M., & Chodosh, J. (2009) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2009.03.014 · Cited by 93 · see citing works
Cognitive Decline and Survival in Alzheimer’s Disease according to Education Level
Bruandet, A., Richard, F., Bombois, S., Maurage, C., Masse, I., Amouyel, P., & Pasquier, F. (2007) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000111693 · Cited by 90 · see citing works
de Bruin, A., Kardaun, J. W. P. F., Gast, F., et al. (2004) · Statistical Journal of the United Nations Economic Commission for Europe · doi:10.3233/sju-2004-21104 · Cited by 80 · see citing works
Reitsma, J. B., Kardaun, J. W. P. F., Gevers, E. F., et al. (2003) · PubMed · Cited by 80 · see citing works
Geerlings, M. I., Deeg, D. J. H., Schmand, B. A., Lindeboom, J., & Jonker, C. (1997) · Neurology · doi:10.1212/wnl.49.3.798 · Cited by 56 · see citing works
Socioeconomic status and survival among older adults with dementia and depression
Chen, R., Hu, Z., Wei, L., & Wilson, K. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.134734 · Cited by 48 · see citing works
Predictors of survival in African American patients with AD, VaD, or stroke without dementia
Freels, S. A., Nyenhuis, D. L., & Gorelick, P. B. (2002) · Neurology · doi:10.1212/wnl.59.8.1146 · Cited by 48 · see citing works
Socioeconomic status in relationship to death of vascular disease and late-life dementia
Goldbourt, U., Beeri, M. S., & Davidson, M. H. (2007) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2007.01.021 · Cited by 47 · see citing works
van de Vorst, I. E., Vaartjes, I. C. H., Sinnecker, L. F., Beks, L. J. M., Bots, M. L., & Koek, H. L. (2015) · PubMed · Cited by 35 · see citing works
Self-citationvan Oeffelen, A. A. M., Agyemang, C. O., Bots, M. L., Stronks, K., Koopman, C., van Rossem, L., & Vaartjes, I. C. H. (2012) · European Journal of Epidemiology · doi:10.1007/s10654-012-9700-z · Cited by 34 · see citing works
Self-citationImpact of socioeconomic status on initial clinical presentation to a memory disorders clinic
Qian, W., Schweizer, T. A., & Fischer, C. E. (2013) · International Psychogeriatrics · doi:10.1017/s1041610213002299 · Cited by 34 · see citing works
Meng, X., D’Arcy, C., Tempier, R., Kou, C., Morgan, D., & Mousseau, D. D. (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2764 · Cited by 12 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Watson, J., Giebel, C., Green, M., Darlington‐Pollock, F., & Akpan, A. (2021) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5419 · Cited by 39 · see citing works
Watson, J., Darlington-Pollock, F., Green, M., Giebel, C., & Akpan, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182413405 · Cited by 21 · see citing works
- Authors
- van de Vorst, I. E., Koek, H. L., Stein, C. E., Bots, M. L., & Vaartjes, I.
- Affiliations
- University Medical Center Utrecht (NL)
- Corresponding author
- Vaartjes, Ilonca
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-07-05
- Volume
- 184
- Issue
- 3
- Pages
- 219-226
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2461984565
- Cited by
- 62
- References
- 35
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 11 · 2023: 6 · 2022: 9 · 2021: 5 · 2020: 12 · 2019: 5 · 2018: 1 · 2017: 2
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- green
- dspace.library.uu.nl
- Licence
- other-oa
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- Alzheimer Nederland (WE.03-2012-38)
- Dutch Heart Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- dementia, socioeconomic status, mortality, household income, socioeconomic disparities, hospitalization, sex differences, prognosis, survival time
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Dementia, Family Characteristics, Female, Humans, Income, Life Expectancy, Male, Medical Record Linkage, Middle Aged, Netherlands, Patient Discharge, Prognosis, Prospective Studies, Registries, Social Class, Time Factors, Health Behavior, Incidence, Prevalence, Proportional Hazards Models, Survival Analysis, Sex Distribution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
