Neighborhood Deprivation, Individual Socioeconomic Status, and Cognitive Function in Older People: Analyses from the English Longitudinal Study of Ageing
Iain A. Lang PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorDavid J. Llewellyn PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorKenneth M. Langa MD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorRobert B. Wallace MD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorFelicia A. Huppert PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorDavid Melzer PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorIain A. Lang PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorDavid J. Llewellyn PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorKenneth M. Langa MD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorRobert B. Wallace MD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorFelicia A. Huppert PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorDavid Melzer PhD
From the * Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom † Institute of Public Health, University of Cambridge, Cambridge, United Kingdom ‡ University of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan § College of Public Health, University of Iowa, Iowa City, Iowa ∥ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Search for more papers by this authorAbstract
OBJECTIVES: To assess the relationship between cognitive function, socioeconomic status, and neighborhood deprivation (lack of local resources of all types, financial and otherwise).
DESIGN: Nationally representative cross-section.
SETTING: The English Longitudinal Study of Ageing (ELSA).
PARTICIPANTS: Seven thousand one hundred twenty-six community-dwelling individuals aged 52 and older and resident in urban areas.
MEASUREMENTS: Individual cognitive function score and index of multiple deprivation (IMD) at the Super Output Area level, adjusting for health, lifestyle, and sociodemographic confounders. Analyses were conducted separately according to sex and age group (52–69 and ≥70).
RESULTS: IMD affected cognitive function independent of the effects of education and socioeconomic status. For example, in fully adjusted models, women aged 70 and older had a standardized cognitive function score (z-score) that was 0.20 points (95% confidence interval (CI)=0.01–0.39) lower in the bottom 20% of wealth than the top 20%, 0.44 points (95% CI=0.20–0.69) lower in the least-educated group than in the most educated, and 0.31 points (95% CI 0.15–0.48) lower if resident lived in an area in the bottom 20% of IMD than in the top 20%.
CONCLUSION: In community-based older people in urban neighborhoods, neighborhood deprivation—living in a neighborhood with high levels of deprivation, compared with national levels—is associated with cognitive function independent of individual socioeconomic circumstances. The mechanisms underlying this relationship are unclear and warrant further investigation.
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