The role of individual and environmental socio-economic resources for cognitive change in very old age.

Soc Sci Med

Cologne Center for Ethics, Rights, Economics and Social Sciences of Health, University of Cologne, Germany.

Published: January 2025

Objectives: Very old adults aged 80+ years old belong to the fastest growing population segment in many countries. Nevertheless, this age group is often underrepresented in studies of cognitive aging. The goal of this study was to examine individual and environmental socio-economic resources as correlates of cognitive aging in very old age.

Method: We used two waves of data from 2017-2018 and 2019-2021 as part of NRW80+, a survey of a population-based sample of very old individuals who are registered with their main residence in North-Rhine Westphalia, the most populous federal state in Germany. The analyses are based on data from 797 participants, who provided data on at least one cognitive test at both waves. Individual socio-economic resources included education, income, wealth, and occupational prestige. Environmental factors were assessed at the municipality level, including population density, unemployment, (public) transportation, broadband availability, healthcare, and libraries. Control variables included age, sex, marital/partner status, living alone, and living in a nursing care institution. Data were analyzed with latent difference score models.

Results: Education and wealth were independently associated with better cognitive function at baseline. None of the individual socio-economic variables was significantly related to change in cognitive function. Beyond these individual characteristics and control variables, higher population density and higher broadband availability, but also higher unemployment rate were associated with better baseline cognitive function. Greater distance to highways, but also fewer hospital beds and a higher number of residents per medical doctor were associated with less decline.

Discussion: Our findings suggest that individual socio-economic resources continue to be associated with better cognitive function in very old age, but are unrelated to short-term cognitive decline. In addition, there is some evidence for associations of baseline cognitive function and cognitive change with environmental factors over and above individual resources. Implications for future research are discussed.

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http://dx.doi.org/10.1016/j.socscimed.2024.117544DOI Listing

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