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Life course financial mobility and later-life memory function and decline by gender, and race and ethnicity: an intersectional analysis of the US KHANDLE and STAR cohort studies.
Kobayashi, Lindsay C; Peterson, Rachel L; Yu, Xuexin; Avila-Rieger, Justina; Amofa-Ho, Priscilla A; Vila-Castelar, Clara; Meza, Erika; Shaaban, C Elizabeth; Whitmer, Rachel A; Gilsanz, Paola; Mayeda, Elizabeth Rose.
Afiliación
  • Kobayashi LC; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, MI, USA. Electronic address: lkob@umich.edu.
  • Peterson RL; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA.
  • Yu X; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, MI, USA.
  • Avila-Rieger J; Taub Institute for Research in Aging and Alzheimer's Disease, Columbia University, New York, NY, USA.
  • Amofa-Ho PA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
  • Vila-Castelar C; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Meza E; Harvard Center for Population and Development Studies, Harvard T H Chan School of Public Health, MA, USA.
  • Shaaban CE; Alzheimer's Disease Research Center and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
  • Whitmer RA; Departments of Public Health Sciences and Neurology, University of California, Davis, CA, USA.
  • Gilsanz P; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.
  • Mayeda ER; Department of Epidemiology, University of California, Davis, CA, USA.
Lancet Healthy Longev ; : 100613, 2024 Aug 28.
Article en En | MEDLINE | ID: mdl-39222645
ABSTRACT

BACKGROUND:

Intersectionality has rarely been considered in research studies of cognitive ageing. We investigated whether life-course financial mobility is differentially associated with later-life memory function and decline across intersectional identities defined by gender, and race and ethnicity.

METHODS:

Data were from two harmonised multiethnic cohorts (the Kaiser Healthy Aging and Diverse Life Experiences cohort and the Study of Healthy Aging in African Americans cohort) in northern California, USA (n=2340). Life-course financial mobility, measured using a combination of self-reported financial capital measures in childhood (from birth to age 16 years) and later adulthood (at the cohort baseline) was defined as consistently high, upwardly mobile, downwardly mobile, or consistently low. We clustered individuals into 32 strata representing intersectional identities defined by life-course financial mobility combined with gender, and race and ethnicity. Verbal episodic memory was assessed using the Spanish and English Neuropsychological Assessment Scales over four waves from 2017 to 2023. Adjusted mixed-effects linear regression models were estimated with and without fixed effects of gender, race and ethnicity, and financial mobility, to evaluate whether the random effects of the intersectional identity strata contributed variance to memory beyond individual fixed effects.

FINDINGS:

Mean age was 73·6 years (SD 8·1). Of 2340 individuals, 1460 (62·4%) were women, 880 (37·6%) were men, 388 (16·6%) were Asian, 1136 (48·5%) were Black, 334 (14·3%) were Latinx, and 482 (20·6%) were White. Consistently low and downwardly mobile financial capital were strongly negatively associated with later-life memory at baseline (-0·162 SD units [95% CI -0·273 to -0·051] for consistently low and -0·171 [-0·250 to -0·092] for downwardly mobile), but not rate of change over time. Intersectional identities contributed 0·2% of memory variance after accounting for the fixed effects of gender, race and ethnicity, and financial mobility.

INTERPRETATION:

Consistently low and downward life-course financial mobility are associated with lower later-life memory function. Intersectional identities defined by financial mobility in addition to gender, and race and ethnicity, contribute negligible additional variance to later-life memory in this study setting.

FUNDING:

US National Institute on Aging, US National Institutes of Health.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Lancet Healthy Longev Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Lancet Healthy Longev Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido