Role of sex in the association between childhood socioeconomic position and cognitive ageing in later life

Katrin Wolfova,Ingemar Kåreholt,Pavla Cermakova,Anna Kagstrom,Zsofia Csajbok

doi:10.1038/s41598-021-84022-1

Abstract

We aimed to explore sex differences in the association of childhood socioeconomic position (SEP) with the level of cognitive performance and the rate of cognitive decline. We studied 84,059 individuals (55% women; mean age 64 years) from the Survey on Health, Ageing and Retirement in Europe. Sex differences in the association of childhood SEP (household characteristics at age 10) with the level of cognitive performance (verbal fluency, immediate recall, delayed recall) were analysed using multilevel linear regression. Structural equation modelling tested education, depressive symptoms and physical state as mediators. The relationship between childhood socioeconomic advantage and disadvantage and the rate of cognitive decline was assessed using linear mixed-effects models. Higher childhood SEP was associated with a higher level of cognitive performance to a greater extent in women (B = 0.122; 95% CI 0.092–0.151) than in men (B = 0.109; 95% CI 0.084–0.135). The strongest mediator was education. Childhood socioeconomic disadvantage was related to a higher rate of decline in delayed recall in both sexes, with a greater association in women. Strategies to prevent impaired late-life cognitive functioning, such as reducing childhood socioeconomic disadvantages and improving education, might have a greater benefit for women.

Highlights

We aimed to explore sex differences in the association of childhood socioeconomic position (SEP) with the level of cognitive performance and the rate of cognitive decline
When stratified by sex and adjusted for age, higher childhood SEP was significantly associated with a higher level of cognitive performance in both sexes, but to a larger extent in women (B = 0.238; 95% confidence interval (CI) 0.203–0.271) than in men (B = 0.208; 95% CI 0.180–0.235; Table 2, Model 1)
When adjusted for education, the model attenuated by 40.3% in women and 39.9% in men but the association of childhood SEP with cognitive performance remained statistically significant in both sexes

Summary

Introduction

We aimed to explore sex differences in the association of childhood socioeconomic position (SEP) with the level of cognitive performance and the rate of cognitive decline. Childhood socioeconomic disadvantage was related to a higher rate of decline in delayed recall in both sexes, with a greater association in women. The effects of childhood poverty on obesity and cardiovascular diseases are disproportionately stronger for w omen[6,7] It is unclear whether these sex differences exist for cognitive health. While mechanisms underlying sex differences related to socioeconomic adversity are likely a complex combination of biopsychosocial variables experienced across the life course, the direction and nature of the relationships of SEP, sex and health have yet to be fully understood. This theory implies that when socio-cultural variables are equal across sexes, the cognitive abilities of men and women have more parity than previously t hought[8]

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