Independent and Joint Associations of Key Social Exposome Components with Cognitive Aging: Triangulating Evidence Through Cross-National Data.

Abstract

We examined the independent and joint associations of five key social exposome components, including financial strain, neighborhood disorder, perceived discrimination, social strain, and traumatic life events, with cognitive function levels and decline. Data were from adults aged > 50 in the US Health and Retirement Study (HRS; n=13,795; 2008-2020) and the English Longitudinal Study of Ageing (ELSA; n=9,469; 2006-2019), and adults aged ≥ 65 in their Harmonized Cognitive Assessment Protocol (HCAP) subsamples (HRS-HCAP: n=2,749; 2016; ELSA-HCAP: n=955; 2018). Using linear mixed-effects models and quantile-based g-computation, we found that all components, except traumatic life events, were associated with lower cognitive function. Simultaneously lowering all components by one quartile could improve cognitive function by 0.09 SD units (95% CI: 0.07-0.11) in the HRS, 0.13 SD units (95% CI: 0.10-0.16) in the ELSA, and 0.07 SD units (95% CI: 0.02-0.13) in the HRS-HCAP. Neighborhood disorder had the strongest negative association with cognitive function in the U.S., while financial strain had the strongest association in England. No social exposome components were associated with faster cognitive decline. The associations of key social exposome components with cognitive function were consistent across countries, although the magnitude of the joint association was greater in England.