Mediating effect of Life's Essential 8 score in the associations of SES mobility with cognitive function, dementia incidence and neuroimaging markers.

OBJECTIVES

To explore the links between SES mobility and dementia incidence, cognitive function, and neuroimaging markers, and to assess whether cardiovascular health mediates these associations.

METHODS

Data were from UK Biobank, involving 130,036 participants aged 40-70 in main analysis. SES mobility was rated via childhood and adulthood SES, and categorized into stable low, upward mobility, downward mobility, stable medium and stable high. Cox and linear regression models were conducted to examine associations of SES mobility with dementia risk, cognitive function, and neuroimaging markers.

RESULTS

Individuals with disadvantaged SES mobility were more likely to experience all-cause dementia (HR = 1.90, 95% CI: 1.55, 2.32), Alzheimer's disease (HR = 2.07, 95% CI: 1.51, 2.83), and vascular dementia (HR = 5.19, 95% CI: 2.65, 10.15) compared to stable high SES. Participants with stable low SES scored lowest in fluid intelligence (β = -1.21, 95% CI: -1.26, -1.15) and numeric memory (β = -0.59, 95% CI: -0.66, -0.53) and had smallest hippocamps volume (β = -163.97, 95% CI: -221.36, -106.57) compared to stable high SES. The above associations were mediated by Life's Essential 8 score, which was measured simultaneously with SES mobility.

CONCLUSION

Disadvantaged SES mobility in transition between childhood and adulthood SES was related to adverse brain health and cardiovascular health mediated these relationships.