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Sahota CM, Cable N, Cadar D. Life-Course Socioeconomic Position and Mild Cognitive Impairment in Midlife: Evidence from the 1958 British Birth Cohort. J Epidemiol Glob Health 2024; 14:102-110. [PMID: 38191951 PMCID: PMC11043258 DOI: 10.1007/s44197-023-00173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Dementia has been the leading cause of death in the UK since 2015. Increasing evidence supports an association between socioeconomic position (SEP) and dementia onset in later life. However, limited studies have examined how life-course SEP influences the development of mild cognitive impairment (MCI), an intermediate state potentially preceding dementia. Therefore, the present study aims to examine the relationship between life-course SEP and MCI amongst adults aged 50 years in Great Britain. METHODS We employed data from the National Child Development Study (NCDS), also known as the 1958 British Birth Cohort, to determine the associations between SEP and MCI in 6590 participants. We categorised life-course measures of SEP as stable high/low or moving upward/downward over the life course. We assessed MCI at age 50 using one standard deviation below the averaged combined scores from all cognitive tests available. We then used binary logistic regression to estimate the longitudinal associations between life-course SEP and MCI. RESULTS Relative to those of a high SEP across the life course, participants who moved upward, downward, or remained at a low SEP were significantly associated with 25% (95% CI 1.02-1.54, p = 0.035), 70% (95% CI 1.27-2.27, p < 0.001), and 85% (95% CI 1.50-2.29, p < 0.001), respectively, higher odds of MCI, independent of all selected covariates. CONCLUSIONS Lower life-course SEP was associated with significantly higher odds of MCI onset in middle life within the NCDS cohort. Public health policies targeting cognitive impairment should encompass a life-course approach to reduce socioeconomic inequalities.
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Affiliation(s)
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK.
- Department of Neuroscience, Brighton and Sussex Medical School, Trafford Centre, Sussex, BN1 9RH, UK.
- Department of Primary Care, Brighton and Sussex Medical School, Sussex, UK.
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Dang Y, Duan X, Rong P, Yan M, Zhao Y, Mi B, Zhou J, Chen Y, Wang D, Pei L. Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China health and nutrition survey. BMC Public Health 2023; 23:1955. [PMID: 37814213 PMCID: PMC10563291 DOI: 10.1186/s12889-023-16881-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The social disparities in obesity may originate in early life or in adulthood, and the associations of socioeconomic position (SEP) with obesity could alter over time. It is unclear how lifetime-specific and life-course SEP influence adult obesity development in China. METHODS Based on the China Health and Nutrition Survey (CHNS), three SEP-related indicators, including the father's occupational position and the participant's education and occupational position, were obtained. The life-course socioeconomic changes and a cumulative SEP score were established to represent the life-course SEP of the participants in the study. The growth mixture modeling was used to identify BMI trajectories in adulthood. Multinomial logistic regression was adopted to assess the associations between SEP and adult BMI trajectories. RESULTS A total of 3,138 participants were included in the study. A positive correlation was found between the paternal occupational position, the participants' occupational position, education, and obesity in males, whereas an inverse correlation was observed among females. Males who experienced social upward mobility or remained stable high SEP during the follow-up had 2.31 and 2.52-fold risks of progressive obesity compared to those with a stable-low SEP. Among females, stable high SEP in both childhood and adulthood was associated with lower risks of progressive obesity (OR = 0.63, 95% CI: 0.43-0.94). Higher risks of obesity were associated with the life-course cumulative SEP score among males, while the opposite relationship was observed among females. CONCLUSIONS The associations between life-course SEP and BMI development trajectories differed significantly by gender. Special emphasis should be placed on males experiencing upward and stable high socioeconomic change.
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Affiliation(s)
- Yusong Dang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China
| | - Xinyu Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China
| | - Peixi Rong
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China
| | - Mingxin Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China
| | - Yaling Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China
| | - Baibing Mi
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China
| | - Jing Zhou
- Department of Pediatrics, The Second Affiliated Hospitical of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, P.R. China
| | - Yulong Chen
- Institute of Basic and Translational Medicine, Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, 710021, Shaanxi, P.R. China
| | - Duolao Wang
- Biostatistics Unit, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
- Department of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Leilei Pei
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China.
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