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Weissberger GH, Han SD, Yu L, Barnes LL, Lamar M, Bennett DA, Boyle PA. Impact of Early Life Socioeconomic Status on Decision Making in Older Adults Without Dementia. Arch Gerontol Geriatr 2021; 95:104432. [PMID: 34034033 DOI: 10.1016/j.archger.2021.104432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A growing body of evidence points to the negative impact of early life socioeconomic status (SES) on health and cognitive outcomes in later life. However, the effect of early life SES on decision making in old age is not well understood. This study investigated the association of early life SES with decision making in a large community-based cohort of older adults without dementia from the Rush Memory and Aging Project. MATERIALS AND METHODS Cross-sectional data from the Rush Alzheimer's Disease Center Memory and Aging Project was analyzed. Participants were 1044 community-dwelling older adults without dementia (M age = 81.15, SD = 7.49; 75.8% female; 5.4% non-White). Measures of financial and healthcare decision making and early life SES were collected, along with demographics, global cognition, and financial and health literacy. RESULTS Early life SES was positively associated with decision making (estimate = 0.218, p = 0.027), after adjustments for demographic covariates and global cognition, such that a one-unit increase in early life SES was equivalent to the effect of being four years younger in age as it pertains to decision making. A subsequent model demonstrated that the relationship was strongest in those with low literacy, and weakest for those with high literacy (estimate = -0.013, p = 0.029). CONCLUSIONS Findings from this study suggest that early life SES is associated with late life decision making and that improving literacy, a modifiable target for intervention, may buffer the negative impact of low early life SES on decision making in older adulthood.
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Affiliation(s)
- Gali H Weissberger
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel 5290002
| | - S Duke Han
- Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, 4th Floor, Room 6437A, Alhambra, CA, 91803, USA; Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, 90089, CA, USA; USC School of Gerontology, Los Angeles, CA, 90089, USA; Department of Neurology, USC Keck School of Medicine, Los Angeles, 90033, CA, USA.
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Neurological Sciences, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences; Department of Neurological Sciences, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Neurological Sciences, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences
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