Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study
Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study
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DOI：
10.1371/journal.pone.0157327
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发表时间：
2016-06-22
期刊：
影响因子：
3.7
通讯作者：
Shih, Regina A.
中科院分区：
文献类型：
--
作者：
Kim, Daniel;Griffin, Beth Ann;Shih, Regina A.
研究目的：老年人个体认知功能的变化仍然无法解释，迄今为止，对区域水平/背景因素的探索很少。收入不平等是一个背景因素，可能considerably影响认知function.MethodsIn一个全国性的代表性队列的美国老年人的健康和退休研究，我们研究了国家和大都市统计区（MSA）水平的收入不平等作为预测指标的个人层面的认知功能测量的27点电话采访认知状态（TICS-M）规模。我们建模的潜伏期为8-20年，并控制状态/大都市统计区（MSA）的水平和个人水平的factors.ResultsHigher MSA水平的收入不平等预测较低的认知功能16-18年后。使用16年的滞后，生活在收入不平等最高的四分位数的MSA中预测TICS-m评分降低0.9分（beta = -0.86; 95%CI =-1.41，-0.31），大致相当于5年老龄化的幅度。我们没有观察到与州一级收入不平等的关联。研究结果是强大的敏感性分析，使用propensity score methods.ConclusionsAmong美国老年人，MSA水平的收入不平等似乎影响认知功能近二十年后。减少城市内收入不平等水平的政策可能有助于解决美国老年人口认知功能下降的日益沉重的负担。
PurposeMuch variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function.MethodsIn a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state-and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8-20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors.ResultsHigher MSA-level income inequality predicted lower cognitive function 16-18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (beta = -0.86; 95% CI = -1.41,-0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods.ConclusionsAmong older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.