High Social Deprivation as a Risk Factor for Dementia: Findings from the longitudinal SHARE study of older Europeans

Abstract

AbstractBackgroundIndividual‐level deprivation indices are only just emerging, but are better indicators than area‐level indices. The Social Deprivation Index (SoDep Index) was developed by our team last year as an indicator of the degree to which an individual experiences socioeconomic deprivation. It has shown a robust association with cognitive status and decline in adults over 50. However, its association with dementia diagnosis is unknown.MethodWe analysed data of > 11, 000 respondents in the Survey of Health, Ageing and Retirement in Europe (SHARE) over the age of 50 who were free of dementia at baseline. Social deprivation status (low, moderate, high) was classified on the basis of SoDep Index scores. The risk of dementia diagnosis was estimated using Cox proportional hazard and Fine and Gray models (correcting for mortality) including social deprivation status and relevant covariates. Further, we completed a sub‐group analysis of individuals with high social deprivation status and analysed the relevance of a history of depression in each deprivation group.ResultResults show that high, compared to low, social deprivation was associated with a significantly increased risk of being diagnosed with dementia. Both, depressive history and depressive symptoms were additionally associated with an increased risk. The associations between depression indicators and dementia risk were particularly pronounced in the high social deprivation sub‐group. Results were robust to correction for mortality.ConclusionSocial deprivation status is associated with an increased dementia risk. This adds to a growing body of evidence indicating that a public health approach to dementia prevention must address socioeconomic inequity. Increased risk in population groups with high social deprivation cannot be accounted for by higher rates of depression. Thus, our results lend additional weight to the argument that adults with depression from vulnerable groups need urgent intervention.