Relationship Between Social Determinants of Health and Cognitive Performance in an Older American Population: a Cross-sectional NHANES Study

Overview

Journal BMC Geriatr

Publisher Biomed Central

Date 2025 Jan 10

PMID 39794733

Authors

Zhen-Guo Yang

Xu Sun

Xue Han

Xiao Wang

Lei Wang

Affiliations

Soon will be listed here.

Abstract

Objective: This study aims to investigate the influence of social determinants of health (SDoH) on cognitive performance.

Methods: This study surveyed a sample of older adults aged 60 years and older from the 2011-2014 cohort of participants in the U.S. National Health and Nutrition Examination Survey (NHANES). Data were collected during each survey cycle on self-reported domains of SDoH, which included eight subscales: employment, family income-to-poverty ratio, food security, education level, health insurance coverage, type of health insurance, home ownership, and marital status. Cognitive performance was evaluated using three tests: the Digit Symbol Substitution Test (DSST) for processing speed, the Animal Fluency Test (AFT) for executive function, and a subtest from the Coalition to Establish an Alzheimer's Disease Registry (CERAD) for memory. Multifactorial linear regression modeling was employed to explore the association between SDoH and cognitive performance.

Results: A total of 2,819 elderly subjects were included in this study for analysis, with a mean age of 69.14 ± 0.19 years, 54.36% female and 45.64% male. The study found a negative association between the accumulation of unfavorable SDoH factors and cognitive performance. Similarly, certain unfavorable SDoH domains were negatively associated with cognitive performance.

Conclusion: The findings suggest that unfavorable SDoH domains, particularly when unfavorable SDoH factors accumulate, are linked to decreased cognitive performance. Actively investigating the relationship between these factors may be a crucial strategy for delaying dementia onset.

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