Abstract
BackgroundThis study seeks to assess the interaction between mid-life socioeconomic status (SES) and city residence on the cognitive status of Baby Boomers and pre-Boomers in Taiwan, a non-Western society with a distinct cultural and family context, taking apolipoprotein E (APOE) gene polymophism and life stressors into consideration.MethodsThe data used was from the Social Environment and Biomarkers of Aging Study (SEBAS) collected in Taiwan during 2006, this involved 1245 individuals from 23 communities and used multilevel regression. General cognitive status was assessed by ten questions via personal interviews. The questions were part of the Short Portable Mental Status Questionnaire, a 10-item free-recall and immediate recall test. Mid-life SES was defined by education and major mid-life occupation of the participant and/or their partner.ResultsMid-life SES was positively associated with cognitive status among both Baby Boomers and pre-Boomers, even after adjusting for APOE polymorphism and stressor covariates. For Baby Boomers, city residents were more likely than town residents to show better cognition (β = 1.47, p < 0.01) and an interaction effect between mid-life SES and city residence was observed (β = −2.12, p < 0.01). While both the Baby Boomer and pre-Boomer cohorts who lived with a partner were reported better cognition, the effects of depressive symptoms and ethnicity differed by cohort.ConclusionsHaving a high level of mid-life SES and living with a partner are associated with better cognition for both cohort groups. An interplay effect between mid-life SES and place of residence on cognition was only found for Baby Boomers. On the other hand, being psychologically depressed was associated with poorer cognition among pre-Boomers. These results underscore the specific roles of mid-life SES, city residence, and life stressors with regard to the cognitive status of Baby Boomers and pre-Boomers in Taiwan.
Highlights
This study seeks to assess the interaction between mid-life socioeconomic status (SES) and city residence on the cognitive status of Baby Boomers and pre-Boomers in Taiwan, a non-Western society with a distinct cultural and family context, taking apolipoprotein E (APOE) gene polymophism and life stressors into consideration
There has been significant scholarly interest in understanding the relationship between severe cognitive impairment and various genetic factors. Such relationships have been well-documented in neuropsychiatric studies [1] and a gene-environment interaction hypothesis has been proposed with respect to the apolipoprotein E4 (APOE4) allele
Despite the above limitations, to our knowledge there has been little research on Asian populations that has used survey data with genetic information in order to explore cohort differences related to the association between mid-life SES, city/town residence, and cognitive status among community-based older adults
Summary
This study seeks to assess the interaction between mid-life socioeconomic status (SES) and city residence on the cognitive status of Baby Boomers and pre-Boomers in Taiwan, a non-Western society with a distinct cultural and family context, taking apolipoprotein E (APOE) gene polymophism and life stressors into consideration. Cognitive impairment of older adults has often been associated with subsequent dementia; this contributes to the global burden associated with this disease, as well as affecting the quality of life of both individuals and families Given this reality, there has been significant scholarly interest in understanding the relationship between severe cognitive impairment and various genetic factors. A related, but somewhat separate hypothesis, which is based on the exposure-disease-stress model, provides a framework that underscores the importance of the inclusion of social stress as a major environmental component in this type of study [6] This model hypothesizes the spatial boundaries associated with the residence of various socioeconomic groups has an effect. The present study hypothesizes that individual socioeconomic status (SES) and the residential context of individuals, together with related stressor factors, work together to create a life stress level that serves as a foundation and exerts a negative influence on an elderly individual’s health, including their cognitive status
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