Is childhood or midlife socioeconomic status more predictive of brain health across race/ethnicity?

Abstract

AbstractBackgroundLower lifecourse socioeconomic status (SES) is associated with worse cognition and greater risk for Alzheimer’s disease (AD). Parental level of educational attainment is one indicator of childhood SES, which predicts myriad health outcomes throughout the lifespan. It is unclear whether midlife SES moderates the impact of childhood SES on midlife outcomes, like brain health. Subgroup differences are important for future risk reduction efforts; therefore, we tested whether midlife SES modifies the influence of childhood SES similarly in White, Black, and Latinx middle‐aged adults.MethodParticipants were 569 middle‐aged older adults drawn from the Offspring study of Racial/Ethnic Disparities in AD (adult children of WHICAP participants), who received MRI (mean age = 54.5 (SD = 10.6) years; 46 non‐Latinx White, 131 non‐Latinx Black, 392 Latinx; 66% women). We used general linear models to examine the relationship of childhood SES (e.g., parental education) with MRI markers of cerebrovascular disease (e.g., white matter hyperintensity volume; WMH) and whether MSES (e.g., educational attainment) moderated this relationship, controlling for sex/gender and age.ResultWhite participants were more likely to have higher childhood SES (F(2,568) = 199.3, p<.001) and MSES (F(2,568) = 36.1, p<.001), followed by Black, then Latinx participants. In the full sample, childhood SES was not associated with WMH volume. Race/ethnicity stratified models revealed that greater childhood SES was associated with lower WMH volume, but only in White participants (B = ‐0.60, CI = ‐0.109,‐0.010). Midlife SES was not associated with WMH volume in the full sample or within each race/ethnicity group. Among White participants, midlife SES did not modify the effect of childhood SES on WMH volume. Midlife SES was unrelated to WMH volume in Black and Latinx participants.ConclusionWe found that childhood SES predicts brain health in middle aged White people. We found racial and ethnic subgroup differences in the relationship of socioeconomic indicators to brain health. However, future studies aim to further understand mechanisms of brain health disparities by considering other SES indicators than parental and offspring education, larger subgroup sample sizes, absolute versus relative SES mobility, other lived experiences, and cognitive outcomes.