Neighborhood Deprivation, Individual Socioeconomic Status, and Cognitive Function in Older People: Analyses from the English Longitudinal Study of Ageing

Authors

  • Iain A. Lang PhD,

    1. From the *Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United KingdomInstitute of Public Health, University of Cambridge, Cambridge, United KingdomUniversity of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan§College of Public Health, University of Iowa, Iowa City, IowaDepartment of Psychiatry, University of Cambridge, Cambridge, United Kingdom
    Search for more papers by this author
  • David J. Llewellyn PhD,

    1. From the *Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United KingdomInstitute of Public Health, University of Cambridge, Cambridge, United KingdomUniversity of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan§College of Public Health, University of Iowa, Iowa City, IowaDepartment of Psychiatry, University of Cambridge, Cambridge, United Kingdom
    Search for more papers by this author
  • Kenneth M. Langa MD,

    1. From the *Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United KingdomInstitute of Public Health, University of Cambridge, Cambridge, United KingdomUniversity of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan§College of Public Health, University of Iowa, Iowa City, IowaDepartment of Psychiatry, University of Cambridge, Cambridge, United Kingdom
    Search for more papers by this author
  • Robert B. Wallace MD,

    1. From the *Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United KingdomInstitute of Public Health, University of Cambridge, Cambridge, United KingdomUniversity of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan§College of Public Health, University of Iowa, Iowa City, IowaDepartment of Psychiatry, University of Cambridge, Cambridge, United Kingdom
    Search for more papers by this author
  • Felicia A. Huppert PhD,

    1. From the *Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United KingdomInstitute of Public Health, University of Cambridge, Cambridge, United KingdomUniversity of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan§College of Public Health, University of Iowa, Iowa City, IowaDepartment of Psychiatry, University of Cambridge, Cambridge, United Kingdom
    Search for more papers by this author
  • David Melzer PhD

    1. From the *Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United KingdomInstitute of Public Health, University of Cambridge, Cambridge, United KingdomUniversity of Michigan and Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan§College of Public Health, University of Iowa, Iowa City, IowaDepartment of Psychiatry, University of Cambridge, Cambridge, United Kingdom
    Search for more papers by this author

Address correspondence to Dr. Iain Lang, Epidemiology & Public Health Group, Peninsula Medical School, RD&E Wonford Site, Barrack Road, Exeter EX2 5DW, UK. E-mail: iain.lang@pms.ac.uk

Abstract

OBJECTIVES: To assess the relationship between cognitive function, socioeconomic status, and neighborhood deprivation (lack of local resources of all types, financial and otherwise).

DESIGN: Nationally representative cross-section.

SETTING: The English Longitudinal Study of Ageing (ELSA).

PARTICIPANTS: Seven thousand one hundred twenty-six community-dwelling individuals aged 52 and older and resident in urban areas.

MEASUREMENTS: Individual cognitive function score and index of multiple deprivation (IMD) at the Super Output Area level, adjusting for health, lifestyle, and sociodemographic confounders. Analyses were conducted separately according to sex and age group (52–69 and ≥70).

RESULTS: IMD affected cognitive function independent of the effects of education and socioeconomic status. For example, in fully adjusted models, women aged 70 and older had a standardized cognitive function score (z-score) that was 0.20 points (95% confidence interval (CI)=0.01–0.39) lower in the bottom 20% of wealth than the top 20%, 0.44 points (95% CI=0.20–0.69) lower in the least-educated group than in the most educated, and 0.31 points (95% CI 0.15–0.48) lower if resident lived in an area in the bottom 20% of IMD than in the top 20%.

CONCLUSION: In community-based older people in urban neighborhoods, neighborhood deprivation—living in a neighborhood with high levels of deprivation, compared with national levels—is associated with cognitive function independent of individual socioeconomic circumstances. The mechanisms underlying this relationship are unclear and warrant further investigation.

Ancillary