Background Socioeconomic position (SEP) across the lifecourse is positively associated with cognitive function in later life in studies of Western populations, with later SEP likely mediating the effect of early life factors. However, it remains to be seen whether similar associations are observed in settings with markedly different social histories with apparently smaller income inequalities. This study aims to investigate the association between measures of SEP reflective of the lifecourse and cognitive function in mid and later life in three Central and Eastern European populations.
Methods Cross-sectional analysis of 7,990 men and women aged 45–69 years in 2002 from the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study recruited in Novosibirsk (Russia), Krakow (Poland), and six Czech towns using random probability sampling. Measures of lifecourse SEP included self-reported childhood socioeconomic conditions (parental education, ownership of household amenities at age 10), own education and current material circumstances. Linear regression was used to estimate the associations between lifecourse SEP measures and three cognitive tests: verbal memory (recall of 10 words), verbal fluency (naming animals) and letter search speed. Fully adjusted models included health and lifestyle covariates (medical history, depression, alcohol, physical activity).
Results Broadly similar patterns of associations were observed across countries. Indicators of SEP across the lifecourse made independent contributions to cognition, with stronger contributions from education and current asset ownership (an indicator of contemporary material circumstances), than from childhood socioeconomic conditions. Socioeconomic advantage was associated with higher levels of cognitive functioning. For example, in fully adjusted models, university education was associated with 3.9 (SE 0.7) word recall advantage in memory performance in Czech men and 2.2 (SE 0.5) and 2.7 (SE 0.3) word advantage in Russian and Polish men; in women these figures were 3.7 (SE 0.4), 3.0 (SE 0.5) and 3.2 (SE 0.3), respectively. The effect of childhood socioeconomic conditions on cognition was largely attenuated after adjustment for education and current material circumstances, suggesting mediation by later SEP measures.
Conclusion Socioeconomic position across the lifecourse is an important predictor of cognition in mid and later life in these Eastern European populations. The attenuation of the effects of childhood SEP after adjustment for own education and current material circumstances supports the model where this association is, at least partly, mediated through later life measures of SEP. Future research should focus on lifecourse influences on cognitive aging trajectories as long-term follow-up of this cohort and other studies in Eastern European populations become available.
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