Persistent financial adversity across adulthood and cognitive ageing: A lifecourse investigation.

Abstract

AbstractBackgroundCognitive decline in older age has significant health, economic and social consequences and there is evidence that financial adversity might play a role. Financial adversity, for many, is not an acute but a chronic stressor. However, little is known about the effect of persistence exposure to financial adversity across the lifecourse on cognitive ageing.MethodUsing data from the 1946 British birth cohort (N = 2,759) with an embedded neuroimaging study (Insight46; N = 356‐468), we examined the prospective association between financial adversity (low household income, financial hardships; 26‐53 years) and cognitive performance (69 years) and decline (53‐69 years), as well as volumetric measures of brain health (69‐71 years) in older adulthood. Cognitive decline was modelled using latent growth curves, with derived intercepts and slopes used in subsequent regression analyses, adjusted for sex, childhood socioeconomic circumstances (SEC), baseline cognition and internalising symptoms, and educational attainment. Sex, childhood SEC and APOE‐ɛ4 genetic risk were further tested as moderators in regression models using interaction terms. This study has been pre‐registered (https://doi.org/10.17605/OSF.IO/6Y9NV).ResultIncreased exposure to financial adversity showed dose‐response associations with slower verbal memory decline and lower processing speed and verbal memory at 69 years (Table 1). Each increased period of exposure to low household income or financial hardships was associated with a 0.11 and 0.08 standard deviation (SD) decrease in processing speed, and a 0.32 and 0.22 SD decrease in verbal memory at 69 years, respectively. Males persistently exposed to financial hardships showed slower processing speed decline but increased brain atrophy compared to females. Those whose fathers were in unskilled profession or unemployed in childhood, and who also persistently experienced low income themselves showed greater brain atrophy (Fig. 1). APOE‐ɛ4 carriers who persistently experienced financial adversity were also at greater risk for brain atrophy (Fig. 2).ConclusionPersistent financial adversity is directly associated with cognitive performance and may be differentially associated with brain atrophy depending on demographic and genetic factors. Reducing the frequency of financial adversity over the lifecourse may improve cognitive performance and protect against genetic susceptibility to brain atrophy and subsequent dementia risk in the ageing population.