Life-course socioeconomic position and incidence of dementia and cognitive impairment without dementia in older Mexican Americans: results from the Sacramento area Latino study on aging

Am J Epidemiol. 2011 May 15;173(10):1148-58. doi: 10.1093/aje/kwq483. Epub 2011 Mar 23.


There have been few investigations of the link between changes in life-course socioeconomic position (SEP) and cognitive decline or incidence of dementia. The authors examined the impact of changes in life-course SEP on incidence of dementia and cognitive impairment but not dementia (CIND) over a decade of follow-up. Participants of Mexican origin (n = 1,789) were members of the Sacramento Area Latino Study on Aging cohort. Incidence of dementia/CIND was ascertained by using standard diagnostic criteria. SEP indicators at 3 life stages (childhood, adulthood, and midlife) were used to derive a measure of cumulative SEP (range, 0 to 8) and SEP mobility. Nearly 24% of the sample maintained a low SEP throughout life. Hazard ratios and 95% confidence intervals were computed from Cox proportional hazards regression models. In fully adjusted models, participants with a continuously high SEP had lower hazard ratios for dementia/CIND compared with those with a continuously low SEP at all 3 life stages (hazard ratio = 0.49, 95% confidence interval: 0.24, 0.98; P = 0.04). In age-adjusted models, participants experienced a 16% greater hazard of dementia/CIND with every 1-unit increase in cumulative SEP disadvantage across the life course (hazard ratio = 1.16, 95% confidence interval: 1.01, 1.33; P = 0.04). Early exposures to social disadvantage may increase the risk of late-life dementia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • California / epidemiology
  • Cognition Disorders / economics
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / etiology
  • Cohort Studies
  • Confidence Intervals
  • Dementia / economics
  • Dementia / epidemiology*
  • Dementia / etiology
  • Female
  • Humans
  • Incidence
  • Male
  • Mexican Americans / psychology
  • Mexican Americans / statistics & numerical data*
  • Middle Aged
  • Poverty / psychology
  • Poverty / statistics & numerical data
  • Proportional Hazards Models
  • Risk Factors
  • Socioeconomic Factors
  • Survival Analysis