Effect of Socioeconomic Status on Incidence of Dementia

Abstract

Background: Dementia is a major public health concern due to increasing prevalence and growing medical burden worldwide. recent studies suggest that socioeconomic adversities across the lifespan increase the risk of dementia, but little is known about its contribution to the risk for dementia. we performed a meta-analysis of all available data to assess how socioeconomic status affect dementia incident risk. Methods: We comprehensively searched Medline, EMBase databases and web of science from inception to December 2017. All studies reported SES data for dementia were included in the meta-analysis. We tested effects of study and participant characteristics in sensitivity analyses and meta-regression and assessed heterogeneity and publication bias. Furthermore, we calculated the pooled risk rates and Population attributable risk (PAR). Findings: We identified 14 articles including 57,004 patients distributed in 15 countries. Dementia risk increased with lower education (OR = 2.40, 95% CI = 1.37, 4.19), unskilled laborers (OR = 1.16, 95% CI = 1.01, 1.34) and lower family asset (OR=1.29, 95% CI=1.04, 1.60). Collectively, these three indicators accounted for 39.73% of the PAR for dementia. Interpretation: We showed a consistent relationship between disadvantage of SES and increased risk of dementia; hence we encourage neuroscientists to consider shifting away from using biologic determination to interpret data, and work instead toward a paradigm of incorporating both biological and socio-environmental factors known to affect health outcomes with the goal of understanding and improving dementia treatments for underserved populations. Funding Statement: The authors state: There was no funding source for this study. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement protocol.