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Neurology. 2019 Nov 12;93(20):e1890-e1899. doi: 10.1212/WNL.0000000000008463. Epub 2019 Oct 2.

Relation between 20-year income volatility and brain health in midlife: The CARDIA study.

Author information

1
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY. leslie.grasset@u-bordeaux.fr.
2
From Université de Bordeaux (L.G.), INSERM, Bordeaux Population Health Research Center, Team VINTAGE UMR1219; Inserm (L.G.), CIC1401-EC, Bordeaux, France; Departments of Epidemiology and Biostatistics (M.M.G., K.Y.), Psychiatry (K.Y.), and Neurology (K.Y.), University of California San Francisco; Division of Epidemiology, Department of Public Health Sciences (T.E., S.L.S.), University of Miami, FL; INSERM U1018 (A.S.-M.), Centre for Research in Epidemiology and Population Health, Paris, France; Department of Epidemiology and Public Health (A.S.-M.), University College London, UK; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.

Abstract

OBJECTIVE:

Income volatility presents a growing public health threat. To our knowledge, no previous study examined the relationship among income volatility, cognitive function, and brain integrity.

METHODS:

We studied 3,287 participants aged 23-35 years in 1990 from the Coronary Artery Risk Development in Young Adults prospective cohort study. Income volatility data were created using income data collected from 1990 to 2010 and defined as SD of percent change in income and number of income drops ≥25% (categorized as 0, 1, or 2+). In 2010, cognitive tests (n = 3,287) and brain scans (n = 716) were obtained.

RESULTS:

After covariate adjustment, higher income volatility was associated with worse performance on processing speed (β = -1.09, 95% confidence interval [CI] -1.73 to -0.44) and executive functioning (β = 2.53, 95% CI 0.60-4.50) but not on verbal memory (β = -0.02, 95% CI -0.16 to 0.11). Similarly, additional income drops were associated with worse performance on processing speed and executive functioning. Higher income volatility and more income drops were also associated with worse microstructural integrity of total brain and total white matter. All findings were similar when restricted to those with high education, suggesting reverse causation may not explain these findings.

CONCLUSION:

Income volatility over a 20-year period of formative earning years was associated with worse cognitive function and brain integrity in midlife.

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