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RESEARCH ARTICLE |
a School of Public Health, Queensland University of Technology, Brisbane, Australia
b Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
c Department of Public Health and General Practice, University of Kuopio, Finland
d Research Institute of Public Health, University of Kuopio, Finland
e Inner Savo Health Centre, Suonenjoki, Finland
Gavin Turrell, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia E-mail: g.turrell{at}qut.edu.au.
Decision Editor: Fredric D. Wolinsky, PhD
Objectives: To examine the influence of childhood and adult socioeconomic position, socioeconomic mobility, and cumulative disadvantage across the lifecourse on cognitive function in late middle age.
Methods: Cross-sectional population-based study of 486 men age 58 and 64 from eastern Finland. Respondent's socioeconomic position in childhood was measured using parent's education and occupation, and respondent's position in adulthood was indicated by attained education and personal income. Cognitive function was assessed using five neuropsychological tests: Trail Making, Selective Reminding, Verbal Fluency, Visual Reproduction, and the Mini-Mental State Exam.
Results: Each indicator of socioeconomic position made statistically independent contributions to levels of cognitive function: Respondents from poor childhood backgrounds, and those who attained a limited education and earned a low income, performed worst on each test. Men who occupied a disadvantaged socioeconomic position in childhood and then experienced upward mobility over the lifecourse exhibited better cognitive performance than those with similar socioeconomic origins but limited or no upward mobility. Conversely, men from advantaged childhood backgrounds who later in life experienced downward mobility scored poorer on each cognitive test than their counterparts who remained in the most advantaged groups throughout the lifecourse. There was a strong, graded association between cumulative socioeconomic disadvantage and cognitive function: Men who occupied a low socioeconomic position during both childhood and adulthood scored worse on every test than those who occupied a high position at all points in their lives.
Discussion: Socioeconomic conditions across all stages of the lifecourse appear to make unique contributions to cognitive function in late middle age. These results also suggest that in terms of cognitive function, origin is not necessarily destiny, as disadvantaged socioeconomic circumstances in childhood may be overcome to some extent by upward mobility later in life.
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