Background Recent work has shown that area conditions at single points in time have been found to be associated with cognitive capability outcomes. However, a life course perspective is required to take into account life time processes of cognitive development, changes in residence and secular trends of areas.
Methods Data from the 1946 British Birth Cohort were used to estimate associations of area deprivation (indicated by % of employed people in each area in partly- or un-skilled occupations) at ages 4, 26 and 53 years (residential addresses linked to census data in 1950, 1972 and 1999) with three measures of cognitive capability at age 53 years: verbal ability [NART], memory and letter cancellation speed. Cross-classified multilevel models were fitted with individuals nested within areas at all three ages. Step-wise models were fitted to assess whether area deprivation was independent of area deprivation at prior time points and current and prior individual socioeconomic position (SEP).
Results The percent of variance explained by lifetime area was 9.9% for NART and 6.8% for word learning scores. There was no variation across areas, or associations with, cancellation speed for any year. For the NART and word learning outcomes, associations were found between higher area deprivation and lower scores, independent of adjustment for individual social class at the same age (i.e. area deprivation at age 4 years adjustment for childhood SEP); however the longitudinal patterns differed. For the NART, an approximately 2 point lower mean score for a 1-standard deviation increase in area deprivation, for each age, was reduced by half but still apparent, when all three area deprivation measures were fitted in the same model [4 years: -1.0 (-1.8, -0.2); 26 years: -1.5 (-2.2, -0.7); 53 years: -1.4 (-2.1, -0.8)]. Yet all were attenuated with the addition of individual SEP measures at all three ages. For memory, both area deprivation at ages 4 and 53 years were independent of adjustment for area deprivation at the other 2 years [4 years: -0.9 (-1.5, -0.2) and 53 years: -1.9 (-2.6, -1.1)], and the latter was still apparent in full models containing all three area deprivation and individual SEP measures [-0.9 (-1.7, -0.2)].
Conclusion The deprivation of the area in which a person resides at different ages in their lives may affect cognitive capability in mid-life, with evidence that long-term exposure to area deprivation may negatively affect cognitive ageing (memory).
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