Neurology. 2021 Jun 7:10.1212/WNL.0000000000012343. doi: 10.1212/WNL.0000000000012343. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate the relationship between late-life duration of poverty exposure and cognitive function and decline among older adults in China.
METHODS: Data were from 3,209 participants aged ≥64 in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Duration of poverty, defined according to urban and rural regional standards from the China Statistical Yearbook, was assessed based on annual household income from 2005-2011 (never in poverty; 1/3 of the period in poverty; ≥2/3 of the period in poverty). Cognitive function was measured by the Chinese Mini Mental State Exam (CMMSE) from 2011-2018. We used attrition-weighted, multivariable mixed-effects Tobit regression to examine the association of duration of poverty with cognitive function and rate of decline.
RESULTS: A total of 1,162 individuals (36.21%) were never in poverty over the period from 2005-2011, 1,172 (36.52%) were in poverty 1/3 of the period, and 875 (27.27%) were in poverty ≥2/3 of the period. A longer poverty duration was associated with lower subsequent CMMSE scores with a dose-response relationship (1/3 vs. never in poverty: β = -0.98; 95% CI: -1.61 to -0.35; ≥2/3 vs. never in poverty: β = -1.55; 95% CI: -2.29 to -0.81). However, a longer duration of poverty was associated with a slower rate of CMMSE score decline over time from 2011-2018.
CONCLUSION: These findings provide valuable evidence on the role of cumulative late-life poverty in relation to cognitive health among older adults in a rapidly urbanizing and aging middle-income country. Our findings may support a compensation hypothesis for cognitive reserve in this setting.
PMID:34099525 | DOI:10.1212/WNL.0000000000012343
