Effect of Individual and District-level Socioeconomic Disparities on Cognitive Decline in Community-dwelling Elderly in Seoul

• Published in: Journal of Korean medical science Vol. 32; no. 9; pp. 1508 - 1515
• Main Authors: Kim, Geon Ha, Lee, Hye Ah, Park, Hyesook, Lee, Dong Young, Jo, Inho, Choi, Seong Hye, Choi, Kyoung-Gyu, Jeong, Jee Hyang
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.09.2017; 대한의학회
• Subjects: Age Factors; Aged; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - economics; Cognitive Dysfunction - epidemiology; Databases, Factual; Female; Humans; Incidence; Longitudinal Studies; Male; Original; Proportional Hazards Models; Retrospective Studies; Risk Factors; Seoul - epidemiology; Sex Factors; Social Class; 의학일반; Individual SES; Cognitive Impairment; District-level SES
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2017.32.9.1508

This study was to investigate the effects of individual and district-level socioeconomic status (SES) on the development of cognitive impairment among the elderly. A 3-year retrospective observational analysis (2010-2013) was conducted which included 136,217 community-dwelling healthy elderly who participated in the Seoul Dementia Management Project. Cognitive impairment was defined as 1.5 standard deviations below the norms on the Mini-mental status examination. In the individual lower SES group, the cumulative incidence rate (CIR) of cognitive impairment was 8.7% (95% confidence interval [CI], 8.64-8.70), whereas the CIR in the individual higher SES group was 4.1% (95% CI, 4.08-4.10). The CIR for lower district-level SES was 4.7% (95% CI, 4.52-4.86), while that in the higher district-level SES was 4.3% (95% CI, 4.06-4.44). There were no additive or synergistic effects between individual and district-level SES. From this study, the individual SES contributed 1.9 times greater to the development of cognitive impairment than the district-level SES, which suggests that individual SES disparities could be considered as one of the important factors in public health related to cognitive impairment in the elderly.