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Proc Natl Acad Sci U S A. 2019 Mar 19;116(12):5478-5486. doi: 10.1073/pnas.1807679116. Epub 2019 Feb 25.

Advantaged socioeconomic conditions in childhood are associated with higher cognitive functioning but stronger cognitive decline in older age.

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Norwegian Social Research, Centre for Welfare and Labour Research, Oslo Metropolitan University, 0170 Oslo, Norway;
LIVES-Overcoming Vulnerability: Life Course Perspectives, Swiss National Centres of Competence in Research, University of Geneva, 1205 Geneva, Switzerland.
Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland.
Institute of Diversity and Social Integration, School of Social Work, ZHAW Zurich University of Applied Sciences, 8005 Zurich, Switzerland.
Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, 1226 Thônex, Switzerland.
Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland.
International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Public Health, University College London, WC1E 6BT London, United Kingdom.


Cognitive aging is characterized by large heterogeneity, which may be due to variations in childhood socioeconomic conditions (CSC). Although there is substantial evidence for an effect of CSC on levels of cognitive functioning at older age, results on associations with cognitive decline are mixed. We examined by means of an accelerated longitudinal design the association between CSC and cognitive trajectories from 50 to 96 years. Cognition included two functions generally found to decline with aging: delayed recall and verbal fluency. Data are from six waves of the Survey of Health, Aging, and Retirement in Europe (SHARE), conducted between 2004 and 2015 (n = 24,066 at baseline; 56% female, age 50+). We found a consistent CSC pattern in levels of cognitive functioning in later life. Older people with disadvantaged CSC had lower levels of cognitive functioning than those with more advantaged CSC. We also find that decline is almost 1.6 times faster in the most advantaged group compared with the most disadvantaged group. The faster decline for people with more advantaged CSC becomes less pronounced when we additionally control for adulthood socioeconomic conditions and current levels of physical activity, depressive symptoms, and partner status. Our findings are in line with the latency, pathway, and cumulative model and lend support to theories of cognitive reserve, stating that neuronal loss can no longer be repaired in people with more cognitive reserve once the underlying pathology is substantial and speed of decline is accelerated.


aging; cognition; life course; life span; socioeconomic position

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