Ari Alex Ramos, Laiss Bertola, Fabiana Araújo Figueiredo da Mata, Matheus Ghossain Barbosa, Vinícius Boaventura, Liana Machado, Maria Fernanda Lima-Costa, Cleusa Pinheiro Ferri
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引用次数: 0
Abstract
Background: The prevalence of cognitive impairment no dementia (CIND) and dementia appears to be higher in low- and middle-income countries (LMICs) compared to high-income economies. Yet few nationally representative studies from Latin American LMICs have investigated life-course socioeconomic factors associated with the susceptibility to these two cognitive conditions. Hence, the present study aimed to examine the associations of early- (education and food insecurity), mid- (employment stability), and late-life (personal income and household per capita income) socioeconomic determinants of CIND and dementia among older adults from Brazil, while simultaneously exploring whether sex plays an effect-modifier role on these associations.
Methods: This population-based study comprised a nationally representative sample of older adults (N = 5,249) aged 60 years and over from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). We fitted multinomial regressions and estimated odds ratios with the respective 95% confidence intervals (CIs).
Results: In multivariate analyses, participants with more years of early-life education (0.89, 95% CI [0.81, 0.97]) and mid-life employment stability (0.97, 95% CI [0.96, 0.99]) and higher late-life household per capita income (0.70, 95% CI [0.51, 0.95) were less likely to have dementia. Regarding CIND, more years of mid-life employment stability (0.97, 95% CI [0.96, 0.98]) was the only determinant to confer protection. Notably, secondary sex-based analyses showed the higher the early-life educational attainment, the lower the odds of dementia in women (0.81, 95% CI [0.75, 0.87]) but not in men (1.00, 95% CI [0.86, 1.16]).
Conclusions: These findings may have implications for population health and health policy by advancing our understanding of socioeconomic determinants of CIND and dementia, especially in Latin America.
背景:与高收入经济体相比,中低收入国家(LMICs)的无痴呆认知障碍(CIND)和痴呆症的发病率似乎更高。然而,拉丁美洲中低收入国家很少有具有全国代表性的研究对与这两种认知疾病易感性相关的生命过程社会经济因素进行调查。因此,本研究旨在探讨巴西老年人CIND和痴呆症的早期(教育和食品不安全)、中期(就业稳定性)和晚期(个人收入和家庭人均收入)社会经济决定因素之间的关联,同时探讨性别是否对这些关联起到调节作用:这项基于人口的研究包括巴西老龄化纵向研究(ELSI-Brazil)中具有全国代表性的 60 岁及以上老年人样本(5249 人)。我们拟合了多项式回归,并估算了几率比例及相应的 95% 置信区间 (CI):在多变量分析中,早年受教育年限越长(0.89,95% CI [0.81,0.97])、中年就业越稳定(0.97,95% CI [0.96,0.99])、晚年家庭人均收入越高(0.70,95% CI [0.51,0.95)的参与者患痴呆症的可能性越小。在 CIND 方面,中年就业稳定性越高(0.97,95% CI [0.96,0.98]),是唯一能提供保护的决定因素。值得注意的是,基于性别的二级分析表明,女性早期受教育程度越高,患痴呆症的几率越低(0.81,95% CI [0.75,0.87]),但男性则不然(1.00,95% CI [0.86,1.16]):这些发现可能会对人口健康和卫生政策产生影响,加深我们对 CIND 和痴呆症的社会经济决定因素的了解,尤其是在拉丁美洲。
期刊介绍:
Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic.
In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation.
Both original work and review articles may be submitted.