Individual socioeconomic status, neighborhood disadvantage, and cognitive aging: A longitudinal analysis of the CLSA.

ABSTRACT

BACKGROUND: There are likely many contributors to variation in the rate of cognitive decline in middle and late adulthood, including individual and neighborhood socio-economic factors. This study examines whether individual socio-economic factors, namely income and wealth, correlate with cognitive decline, in part, through neighborhood-level social and material disadvantage. METHODS: Using the three waves of data collection from the Canadian Longitudinal Study on Aging (CLSA), this study included 51,338 participants between the age of 45 and 85 years at baseline (51% female). Individual socio-economic status (SES) was assessed by annual household income and by the current value of savings and investments. Neighborhood disadvantage was measured by area-based material and social deprivation indices. Cognition was measured at each wave using verbal fluency, mental alternations, and delayed word recall. Latent change score models, incorporating direct and indirect pathways, were constructed to estimate the indirect effect of individual SES on cognitive change through area-level disadvantage. Multi-group models were constructed on the basis of age-group (45-64 years; 65-74 years; or 75+ years) to allow for varying estimates across age. RESULTS: Among 45-64-year-olds, income and wealth had indirect effects on initial cognitive level and on rate of cognitive decline through material disadvantage (standardized indirect effects = 0.01, p < 0.001), but only wealth had an indirect effect through social disadvantage (p = 0.019). Among 65-74-year-olds, income and wealth had indirect effects on initial cognitive level (p < 0.01) but not on rate of cognitive decline (p > 0.05), and among 75+ year-olds, no indirect effects were observed (p > 0.05). Wealth and income had direct effects, independent of neighborhood disadvantage, on cognition in all age groups (p < 0.05). CONCLUSIONS: Among middle-aged adults, greater individual SES may mitigate cognitive decline, in part, by allowing individuals to live in more materially and socially advantaged neighborhoods.