Work

Systematic review of the association between life-course socioeconomic status and late-life cognitive decline

Year: 2025

Type: review

Abstract: BACKGROUND: Socioeconomic status (SES) is a potentially important upstream determinant of late-life cognitive health, but a review which captures the dynamic influence of SES across the life-course is lacking. We conducted a systematic review of studies reporting associations between life-course SES and dementia/late-life cognitive decline. METHODS: On 21 February 2024, we searched Medline, Embase, PsycINFO, CINAHL, British Education Index, Web of Science, Scopus and Advanced Google for studies related to life-course SES and dementia. We included studies employing trajectory or mediation analysis that measured dementia/cognitive decline as outcomes. Two researchers independently screened articles and assessed risk of bias. Results were synthesised narratively and in Harvest plots. RESULTS: We included 18 out of 6040 studies screened (n=7 trajectory studies, n=8 mediation studies, n=3 both). Most (13/23) trajectory analyses reported that stable low SES and downward social mobility, relative to stable high SES/upward mobility, were linked to higher dementia and/or cognitive decline risk. Half (5/10) of the mediation analyses reported full mediation of adulthood SES on the association between childhood SES and dementia/cognitive decline, and 4/10 reported partial mediation. Overall, study quality was moderate. CONCLUSION: SES has a dynamic life-course association with dementia risk. Increases in dementia risk are compounded by sustained life-course disadvantage. Policies to address socioeconomic disadvantage across the life-course are needed to address this upstream determinant of dementia. PROSPERO REGISTRATION NUMBER: CRD42024505975.

Source: Journal of Epidemiology & Community Health

DOI: 10.1136/jech-2025-223864

Authors: Eleanor I Williams, Isla Kuhn, Carol E Brayne, Sebastian Walsh

Institution: University of Cambridge

Language: English

Topic: Dementia and Cognitive Impairment Research

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Funder: National Institute for Health and Care Research