Subjective social position and cognitive function in a longitudinal cohort of older, rural South African adults, 2014–2019
Year: 2021
Type: article
Study design: Observational Study
Abstract: Background The relationship between subjective social position (SSP) and cognitive ageing unclear, especially in low-income settings. We aimed to investigate the relationship between SSP and cognitive function over time among older adults in rural South Africa. Methods Data were from 3771 adults aged ≥40 in the population-representative ‘Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa’ from 2014/2015 (baseline) to 2018/2019 (follow-up). SSP was assessed at baseline with the 10-rung MacArthur Network social position ladder. Outcomes were composite orientation and episodic memory scores at baseline and follow-up (range: 0–24). Mortality- and attrition-weighted linear regression estimated the associations between baseline SSP with cognitive scores at each of the baseline and follow-up. Models were adjusted for age, age2, sex, country of birth, father’s occupation, education, employment, household assets, literacy, marital status and health-related covariates. Results SSP responses ranged from 0 (bottom ladder rung/lowest social position) to 10 (top ladder rung/highest social position), with a mean of 6.6 (SD: 2.3). SSP was positively associated with baseline cognitive score (adjusted β=0.198 points per ladder rung increase; 95% CI 0.145 to 0.253) and follow-up cognitive score (adjusted β=0.078 points per ladder rung increase; 95% CI 0.021 to 0.136). Conclusion Independent of objective socioeconomic position measures, SSP is associated with orientation and episodic memory scores over two time points approximately 3 years apart among older rural South Africans. Future research is needed to establish the causality of the observed relationships, whether they persist over longer follow-up periods and their consistency in other populations.
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: Aging and IL-7-mediated CD8+ T Cell survival, G3003890976, Health, population and social transitions in rural Southern Africa: Elucidating pathways and testing interventions., Preventing cardiometabolic diseases in Africa: life-course and multi-sector approaches., Using social networks to understand and intervene on HIV epidemic spread, Investigating and responding to health, population and social transitions in rural Southern Africa., G493219187, G6508677287, G8186070293, Socioeconomic and Cardiovascular Sources of Cross-National Variation in Cognitive Health Among Older Adults
OpenAlex ID: W3200057570