Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England

Cadar, Dorina, Lassale, Camille, Davies, Hilary, Llewellyn, David J, Batty, David and Steptoe, Andrew (2018) Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England JAMA Psychiatry, 75 (7). pp. 723-732.

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Abstract

IMPORTANCE

Lower educational attainment is associated with a higher risk of dementia. However, less clear is the extent to which other socioeconomic markers contribute to dementia risk.

OBJECTIVE

To examine the relationship of education, wealth, and area-based deprivation with the incidence of dementia over the last decade in England and investigate differences between people born in different periods.

DESIGN, SETTING, AND PARTICIPANTS

Data from the English Longitudinal Study of Ageing, a prospective cohort study that is representative of the English population, were used to investigate the associations between markers of socioeconomic status (wealth quintiles and the index of multiple deprivation) and dementia incidence. To investigate outcomes associated with age cohorts, 2 independent groups were derived using a median split (born between 1902-1925 and 1926-1943).

MAIN OUTCOMES AND MEASURES

Dementia as determined by physician diagnosis and the Informant Questionnaire on Cognitive Decline in the Elderly.

RESULTS

A total of 6220 individuals aged 65 years and older enrolled in the study (median [interquartile range] age at baseline, 73.2 [68.1-78.3] years; 3410 [54.8%] female). Of these, 463 individuals (7.4%) had new cases of dementia ascertained in the 12 years between 2002-2003 and 2014-2015. In the cohort born between 1926 and 1943, the hazard of developing dementia was 1.68 times higher (hazard ratio [HR] = 1.68 [95%CI, 1.05-2.86]) for those in the lowest wealth quintile compared with those in the highest quintile, independent of education, index of multiple deprivation, and health indicators. Higher hazards were also observed for those in the second-highest quintile of index of multiple deprivation (HR = 1.62 [95%CI, 1.06-2.46]) compared with those in the lowest (least deprived) quintile.

CONCLUSIONS AND RELEVANCE

In an English nationally representative sample, the incidence of dementia appeared to be socioeconomically patterned primarily by the level of wealth. This association was somewhat stronger for participants born in later years.

Item Type:	Article
Divisions :	Faculty of Health and Medical Sciences > School of Health Sciences
Authors :	Name Email ORCID Cadar, Dorina Lassale, Camille Davies, Hilary hilary.davies@surrey.ac.uk Llewellyn, David J Batty, David Steptoe, Andrew
Date :	16 May 2018
Funders :	ESRC
DOI :	10.1001/jamapsychiatry.2018.1012
Copyright Disclaimer :	This is an open access article distributed under the terms of the CC-BY License. © 2018 Cadar D et al. JAMA Psychiatry.
Additional Information :	Correction: This article was corrected on July 3, 2018, to clarify ambiguous statements in the Results section of the Abstract and the Findings section of the Key Points that affected interpretation.
Depositing User :	Melanie Hughes
Date Deposited :	29 Aug 2018 11:10
Last Modified :	29 Aug 2018 11:10
URI:	http://epubs.surrey.ac.uk/id/eprint/849149

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