TY - JOUR T1 - Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study. JF - PLoS One Y1 - 2016 A1 - Kim, Daniel A1 - Griffin, Beth Ann A1 - Mohammed U Kabeto A1 - José J Escarce A1 - Kenneth M. Langa A1 - Regina A Shih ED - M. Maria Glymour KW - Cities KW - Cognition KW - Female KW - health KW - Humans KW - Income KW - Interviews as Topic KW - Linear Models KW - Male KW - Middle Aged KW - Multivariate Analysis KW - Residence Characteristics KW - Retirement KW - Socioeconomic factors KW - Statistics as Topic KW - Telephone KW - United States AB -

PURPOSE: Much 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.

METHODS: In 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.

RESULTS: Higher 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 (β = -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.

CONCLUSIONS: Among 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.

VL - 11 UR - http://dx.doi.org/10.1371/journal.pone.0157327 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27332986?dopt=Abstract JO - PLoS ONE ER -