93 Impact of Childhood Socioeconomic Status on Subjective Cognitive Decline
Authors: Garriga Stella M , Joyce Jillian , Azar Martina , Waltrip Leah , Zeiger Peter , Shagalow Shaina , Rizer Sandra , Kann Michael , Hernandez Michelle , Cosentino Stephanie 
Published: December 2023

Objective:

Subjective cognitive decline (SCD) is increasingly being considered one of the earliest clinical signs of Alzheimer’s Disease (AD). Certain characteristics of early life, such as childhood socioeconomic status (SES), have been associated with late life cognitive performance. Here we examine the extent to which childhood SES predicts SCD.

Participants and Methods:

The current sample consisted of 55 healthy older adults (17 Male, 39 Female), aged 51 to 88 (M=73.14, SD=6.23) with a mean education of 16 years (SD=2.1 years). 21.5% of the sample self-reported as race/ethnic minorities (e.g., Hispanic or Non-Hispanic African American, Asian, Other.) Participants completed a 20-item SCD questionnaire assessing perceived cognitive difficulties in comparison to same aged peers, and objective cognitive testing. Childhood SES was assessed using two items. The first item asked the participant to utilize a modified MacArthur Scale of Subjective Social Status to identify where on the ladder they felt their family would have been placed during their childhood relative to others in the United States. This ladder has 10 rungs, with rung 1 associated with being the “worst off” and rung 10 associated with being the “best off”. The second item asked the participant to rate their family’s difficulty paying bills during their childhood. Linear regression models were used to examine the extent to which childhood SES predicted SCD. Models were adjusted for education, referral source (clinical versus non-clinical), and objective cognitive testing. Age and gender were not associated with childhood SES or SCD, and as a result were not adjusted for in these models.

Results:

On the MacArthur Scale, 20% of participants placed their family at rung 5, 38.2% placed their families at a rung lower than 5, and 41.8% placed their family at a rung higher than 5. When rating the difficulty their family faced paying bills, 3.6% of participants responded “extremely difficult”, 16.4% responded “very difficult”, 20% responded “somewhat difficult”, 23.6% responded “slightly difficult”, and 36.4% responded “not difficult”. Linear regression models revealed a significant effect of childhood SES on SCD (β=-.29, p=.045, SE=.90; β=-.35, p=.015, SE=1.68).

Conclusions:

Childhood SES, measured by subjective social status and family’s difficulty paying the bills in childhood, was predictive of SCD in this study of cognitively healthy adults. This result highlights another characteristic of early life that may shape the path of cognitive aging. The predictive utility of childhood SES for SCD may also provide clinicians and researchers with further insight into the populations that may be more susceptible to experiencing SCD in later life. Future studies should utilize a larger sample size among a population with a greater range of childhood SES, to most accurately capture the effectiveness of childhood SES to predict SCD.