Gender differences in the association of childhood socioeconomic status and late‐life cognition among African Americans: Findings from the STAR study: Epidemiology: Early life exposures in diverse cohorts. (7th December 2020)

• Record Type: Journal Article
• Authors: Barnes, Lisa L; Peterson, Rachel; George, Kristen M; Gilsanz, Paola; Mungas, Dan M; Glymour, M Maria; Mayeda, Elizabeth Rose; Whitmer, Rachel A
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 10
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.045472
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Low socioeconomic status in childhood has been linked with poor cognitive function in old age. But few studies have focused on African Americans or evaluated gender differences. We examined cross‐sectional associations of childhood socioeconomic factors with late‐life cognition and effect modification by gender. Methods: Study of Healthy Aging in African Americans (STAR) participants were 722 African Americans (69% women; mean age = 68.4 and education: 60% <High school) community‐residing long‐term members of Kaiser Permanente Northern California. Summary scores in 3 cognitive domains (executive function, semantic memory, verbal memory) and a global cognition composite were based on the Spanish and English Neuropsychological Assessment Scales (SENAS). Participants rated frequency of experiencing hunger as a child (sometimes/often vs. rarely/never), their family's financial status (average/high vs. poor), and parental education (>= high school vs. < high school), as indicators of childhood SES. Linear regression models adjusted for age were used to examine childhood SES and late‐life cognition, and effect modification by gender. Results: There were no gender differences in experiencing childhood hunger (p=.08), having poor family finances (p=0.30), or parental education (p=0.17). In the pooled model with women and men, higher frequency of childhood hunger was associated with worse cognition overall (β=‐0.36, 95% CI=‐0.66, ‐0.06) and in all domains (executive: β=‐0.32, 95% CI=‐0.63, ‐0.01; semantic: β=‐0.38, 95% CI=‐0.53, ‐0.23; verbal: β=‐0.42, 95% CI=‐0.73, ‐0.12). Low parental education was only associated with lower global cognition β=‐0.18, 95% CI=‐0.33, ‐0.02 and semantic memory (β=‐0.40, 95% CI=‐0.57, ‐0.23). Childhood family financial status was not associated with late‐life cognition. In gender‐stratified models, women who reported greater frequency of childhood hunger had worse cognition in every domain except semantic memory (overall: β=‐0.53, 95% CI=‐0.94, ‐0.13; executive: β=‐0.61, 95% CI=‐1.01, ‐0.20; semantic: β=‐0.21 95% CI=‐0.64, 0.21; verbal: β=‐0.46, 95% CI=‐0.87, ‐0.06). In contrast, childhood hunger was not associated with cognition in men (overall: β=‐0.14, 95% CI=‐0.59, 0.32; executive: β=0.11, 95% CI=‐0.35, 0.58; semantic: β=‐0.05 95% CI=‐0.57, 0.48; verbal: β=‐0.40, 95% CI=‐0.88, 0.08), but low parental education was associated with semantic memory (β=‐0.43, 95% CI=‐0.73, ‐0.14). Conclusion: Childhood hunger is associated with worse cognition in old age, particularly among women.