Sustained Economic Hardship and Cognitive Function: The Coronary Artery Risk Development in Young Adults Study

Adina Zeki Al Hazzouri, Tali Elfassy, Stephen Sidney, David Jacobs, Eliseo J. Pérez Stable, Kristine Yaffe

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Introduction: The relationship between low income and worse health outcomes is evident, yet its association with cognitive outcomes is less explored. Most studies have measured income at one time and none have examined how sustained exposure to low income influences cognition in a relatively young cohort. This study examined the effect of sustained poverty and perceived financial difficulty on cognitive function in midlife. Methods: Income data were collected six times between 1985 and 2010 for 3,383 adults from the Coronary Artery Risk Development in Young Adults prospective cohort study. Sustained poverty was defined by the percentage of time participants' household income was <200% of the federal poverty level-never in poverty, 0< to <1/3, ≥1/3 to <100% or all-time. In 2010, at a mean age of 50 years, participants underwent a cognitive battery. Data were analyzed in 2015. Results: In demographic-adjusted linear regression models, individuals with all-time poverty performed significantly worse than individuals never in poverty: 0.92 points worse on verbal memory (z-score, -0.28; 95% CI=-0.43, -0.13), 11.60 points worse on processing speed (z-score, -0.72; 95% CI=-0.85, -0.58), and 3.50 points worse on executive function (z-score, -0.32; 95% CI=-0.47, -0.17). Similar results were observed with perceived financial difficulty. Findings were robust when restricted to highly educated participants, suggesting little evidence for reverse causation. Conclusions: Cumulative exposure to low income over 2 decades was strongly associated with worse cognitive function of a relatively young cohort. Poverty and perceived hardship may be important contributors to premature aging among disadvantaged populations.

Original languageEnglish (US)
JournalAmerican Journal of Preventive Medicine
DOIs
StateAccepted/In press - 2016

Fingerprint

Poverty
Cognition
Young Adult
Coronary Vessels
Economics
Linear Models
Premature Aging
Executive Function
Vulnerable Populations
Causality
Cohort Studies
Demography
Prospective Studies
Health
Population

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Sustained Economic Hardship and Cognitive Function : The Coronary Artery Risk Development in Young Adults Study. / Zeki Al Hazzouri, Adina; Elfassy, Tali; Sidney, Stephen; Jacobs, David; Pérez Stable, Eliseo J.; Yaffe, Kristine.

In: American Journal of Preventive Medicine, 2016.

Research output: Contribution to journalArticle

@article{be476233ab4747d8a8c5f1cc49a56f19,
title = "Sustained Economic Hardship and Cognitive Function: The Coronary Artery Risk Development in Young Adults Study",
abstract = "Introduction: The relationship between low income and worse health outcomes is evident, yet its association with cognitive outcomes is less explored. Most studies have measured income at one time and none have examined how sustained exposure to low income influences cognition in a relatively young cohort. This study examined the effect of sustained poverty and perceived financial difficulty on cognitive function in midlife. Methods: Income data were collected six times between 1985 and 2010 for 3,383 adults from the Coronary Artery Risk Development in Young Adults prospective cohort study. Sustained poverty was defined by the percentage of time participants' household income was <200{\%} of the federal poverty level-never in poverty, 0< to <1/3, ≥1/3 to <100{\%} or all-time. In 2010, at a mean age of 50 years, participants underwent a cognitive battery. Data were analyzed in 2015. Results: In demographic-adjusted linear regression models, individuals with all-time poverty performed significantly worse than individuals never in poverty: 0.92 points worse on verbal memory (z-score, -0.28; 95{\%} CI=-0.43, -0.13), 11.60 points worse on processing speed (z-score, -0.72; 95{\%} CI=-0.85, -0.58), and 3.50 points worse on executive function (z-score, -0.32; 95{\%} CI=-0.47, -0.17). Similar results were observed with perceived financial difficulty. Findings were robust when restricted to highly educated participants, suggesting little evidence for reverse causation. Conclusions: Cumulative exposure to low income over 2 decades was strongly associated with worse cognitive function of a relatively young cohort. Poverty and perceived hardship may be important contributors to premature aging among disadvantaged populations.",
author = "{Zeki Al Hazzouri}, Adina and Tali Elfassy and Stephen Sidney and David Jacobs and {P{\'e}rez Stable}, {Eliseo J.} and Kristine Yaffe",
year = "2016",
doi = "10.1016/j.amepre.2016.08.009",
language = "English (US)",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Sustained Economic Hardship and Cognitive Function

T2 - The Coronary Artery Risk Development in Young Adults Study

AU - Zeki Al Hazzouri, Adina

AU - Elfassy, Tali

AU - Sidney, Stephen

AU - Jacobs, David

AU - Pérez Stable, Eliseo J.

AU - Yaffe, Kristine

PY - 2016

Y1 - 2016

N2 - Introduction: The relationship between low income and worse health outcomes is evident, yet its association with cognitive outcomes is less explored. Most studies have measured income at one time and none have examined how sustained exposure to low income influences cognition in a relatively young cohort. This study examined the effect of sustained poverty and perceived financial difficulty on cognitive function in midlife. Methods: Income data were collected six times between 1985 and 2010 for 3,383 adults from the Coronary Artery Risk Development in Young Adults prospective cohort study. Sustained poverty was defined by the percentage of time participants' household income was <200% of the federal poverty level-never in poverty, 0< to <1/3, ≥1/3 to <100% or all-time. In 2010, at a mean age of 50 years, participants underwent a cognitive battery. Data were analyzed in 2015. Results: In demographic-adjusted linear regression models, individuals with all-time poverty performed significantly worse than individuals never in poverty: 0.92 points worse on verbal memory (z-score, -0.28; 95% CI=-0.43, -0.13), 11.60 points worse on processing speed (z-score, -0.72; 95% CI=-0.85, -0.58), and 3.50 points worse on executive function (z-score, -0.32; 95% CI=-0.47, -0.17). Similar results were observed with perceived financial difficulty. Findings were robust when restricted to highly educated participants, suggesting little evidence for reverse causation. Conclusions: Cumulative exposure to low income over 2 decades was strongly associated with worse cognitive function of a relatively young cohort. Poverty and perceived hardship may be important contributors to premature aging among disadvantaged populations.

AB - Introduction: The relationship between low income and worse health outcomes is evident, yet its association with cognitive outcomes is less explored. Most studies have measured income at one time and none have examined how sustained exposure to low income influences cognition in a relatively young cohort. This study examined the effect of sustained poverty and perceived financial difficulty on cognitive function in midlife. Methods: Income data were collected six times between 1985 and 2010 for 3,383 adults from the Coronary Artery Risk Development in Young Adults prospective cohort study. Sustained poverty was defined by the percentage of time participants' household income was <200% of the federal poverty level-never in poverty, 0< to <1/3, ≥1/3 to <100% or all-time. In 2010, at a mean age of 50 years, participants underwent a cognitive battery. Data were analyzed in 2015. Results: In demographic-adjusted linear regression models, individuals with all-time poverty performed significantly worse than individuals never in poverty: 0.92 points worse on verbal memory (z-score, -0.28; 95% CI=-0.43, -0.13), 11.60 points worse on processing speed (z-score, -0.72; 95% CI=-0.85, -0.58), and 3.50 points worse on executive function (z-score, -0.32; 95% CI=-0.47, -0.17). Similar results were observed with perceived financial difficulty. Findings were robust when restricted to highly educated participants, suggesting little evidence for reverse causation. Conclusions: Cumulative exposure to low income over 2 decades was strongly associated with worse cognitive function of a relatively young cohort. Poverty and perceived hardship may be important contributors to premature aging among disadvantaged populations.

UR - http://www.scopus.com/inward/record.url?scp=84998816233&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84998816233&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2016.08.009

DO - 10.1016/j.amepre.2016.08.009

M3 - Article

C2 - 27692543

AN - SCOPUS:84998816233

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

ER -