Socioeconomic inequalities in cognitive performance among early ageing people: The Constances cohort
Résumé
Background:In spite of the recent awareness of environmental character-istic’s impact on brain aging, links between contextualsocioeconomic status and cognitive performance (CP) remainsunclear. The objective was to investigate the influence ofindividual and contextual deprivation on cognitive perfor-mance in order to better characterize vulnerable population.Methods:We performed cross-sectional analyses on 44,762 participants(45-70 y) of the French Constances cohort. Cognitiveperformance was assessed using a global cognitive scorecalculated with 6 cognitive tests evaluating global cognitivefunction, episodic verbal memory, language abilities, andexecutive functions. Poor performance was defined as a scorebelow or equal to the 25th percentile of the distribution. Weapproached the deprivation by two validated multidimensionalindex: at individual level with the EPICES score (deprivedif < 30.17) and contextual level with the FDep09 score dividedin quintile (Q5 being the most deprived). Associations wereestimated with multilevel logistic regressions.Results:At the individual level, participants more deprived had poorerCP independently to sex, age, education and health status (OR1.58 [1.48; 1.69]). At the contextual level, the more peoplelived in deprived environment, the poorer their CP (p<.0001),even after adjustment on individual deprivation and otherindividual characteristics (Q5 vs Q1: OR 1.28 [1.15; 1.41]).Conclusions:In this large cohort of early-ageing people, area-baseddisparities in cognitive impairment were highlighted. Abetter understanding of the influence of living environmentdeprivation level on cognitive aging could help to define newstrategies in prevention by targeting at-risk populations in interventions studies in order to reduce social healthinequalities.Key messages:-Our study evidenced a strong socio-economic gradient ofcognitive performance identifiable on both individual andcontextual level, in a large sample of middle-agedvolunteers.-Independently to individual deprivation and other indivi-dual characteristics, living in a deprived environment maybe detrimental to the brain health
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