Background Adverse childhood socioeconomic status (cSES) predicts higher late-life risk of memory loss and dementia. Veterans of U.S. wars are eligible for educational and economic benefits that may offset cSES disadvantage. We test whether cSES disparities in late-life memory and dementia are smaller among veterans than non-veterans.
Methods Data came from US-born men in the 1995–2014 biennial surveys of the Health and Retirement Study (n=7916 born 1928–1956, contributing n=38 381 cognitive assessments). Childhood SES was represented by maternal education. Memory and dementia risk were assessed with brief neuropsychological assessments and proxy reports. Military service (veteran/non-veteran) was evaluated as a modifier of the effect of maternal education on memory and dementia risk. We employed linear or logistic regression models to test whether military service modified the effect of maternal education on memory or dementia risk, adjusted for age, race, birthplace and childhood health.
Results Low maternal education was associated with worse memory than high maternal education (β = −0.07 SD, 95% CI −0.08 to –0.05), while veterans had better memory than non-veterans (β = 0.03 SD, 95% CI 0.02 to 0.04). In interaction analyses, maternal education disparities in memory were smaller among veterans than non-veterans (difference in disparities = 0.04 SD, 95% CI 0.01 to 0.08, p = 0.006). Patterns were similar for dementia risk.
Conclusions Disparities in memory by maternal education were smaller among veterans than non-veterans, suggesting military service and benefits partially offset the deleterious effects of low maternal education on late-life cognitive outcomes.
- health inequalities
- life course epidemiology
- social epidemiology
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Contributors AMV, ERM, SB and MMG conceptualised the study. AMV led the data analysis, interpreted the results and wrote the first draft of the paper. CWE, ERM and JRM contributed to the data analysis and interpretation. AMV, ERM, SB, RH and MMG contributed to the framing of the manuscript. All authors reviewed and approved the final manuscript.
Funding Research reported in this publication was supported by the Stanford Center on the Demography and Economics of Health and Aging pilot grants program (AMV), under a parent award from the National Institute on Aging under Award Number AG017253 (Bhattacharya), the National Institute on Minority Health And Health Disparities under Award Number DP2MD010478 (SB) and the National Institute on Aging under Award Number K99AG053410 (ERM).
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.