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Socioeconomic area deprivation and its relationship with dementia, Parkinson's Disease and all-cause mortality among UK older adults: a multistate modeling approach

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Listed:
  • Beydoun, May A.
  • Georgescu, Michael F.
  • Weiss, Jordan
  • Noren Hooten, Nicole
  • Beydoun, Hind A.
  • Tsai, Jack
  • Maino Vieytes, Christian A.
  • Evans, Michele K.
  • Zonderman, Alan B.

Abstract

The study analyzed the association of area-level socioeconomic status (SES) with the risk of all-cause dementia, Parkinson's Disease (PD), and all-cause mortality using a multistate approach. Data from the UK Biobank were used (N = 363,663 50+y individuals, ≤15y follow-up), and Cox proportional hazards and multistate parametric models including Weibull regression were conducted, while cardiovascular health was tested as a potential mediator. In multistate models, socioeconomic area-level deprivation, measured by the Townsend Deprivation Index (TDI) z-score, was positively associated with the hazard of going from healthy into the 3 states of PD, dementia, and all-cause mortality (i.e. transitions 1: HR = 1.06, 95 % CI:1.02–1.10, P = 0.005, 2: HR = 1.19, 95 % CI: 1.16–1.22, P < 0.001 and 3: HR = 1.19, 95 % CI: 1.18–1.21, P < 0.001), with no association detected for transitions 4 (PD→Dementia), 5 (PD→Death), or 6 (Dementia→Death). Cardiovascular health did not mediate these associations. Socioeconomic area-level deprivation was directly associated with reduced survival rates from Healthy into Dementia, PD and Death.

Suggested Citation

  • Beydoun, May A. & Georgescu, Michael F. & Weiss, Jordan & Noren Hooten, Nicole & Beydoun, Hind A. & Tsai, Jack & Maino Vieytes, Christian A. & Evans, Michele K. & Zonderman, Alan B., 2025. "Socioeconomic area deprivation and its relationship with dementia, Parkinson's Disease and all-cause mortality among UK older adults: a multistate modeling approach," Social Science & Medicine, Elsevier, vol. 379(C).
    • Handle: RePEc:eee:socmed:v:379:y:2025:i:c:s0277953625004678
    DOI: 10.1016/j.socscimed.2025.118137
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    References listed on IDEAS

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    1. James Watson & Frances Darlington-Pollock & Mark Green & Clarissa Giebel & Asangaedem Akpan, 2021. "The Impact of Demographic, Socio-Economic and Geographic Factors on Mortality Risk among People Living with Dementia in England (2002–2016)," IJERPH, MDPI, vol. 18(24), pages 1-14, December.
    2. Martin Fischer & Martin Lövdén & Therese Nilsson & Dominika Seblova & Marc A Garcia, 2023. "Very Early-Life Risk Factors for Developing Dementia: Evidence From Full Population Registers," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 78(12), pages 2131-2140.
    3. Archana Singh-Manoux & Aurore Fayosse & Séverine Sabia & Adam Tabak & Martin Shipley & Aline Dugravot & Mika Kivimäki, 2018. "Clinical, socioeconomic, and behavioural factors at age 50 years and risk of cardiometabolic multimorbidity and mortality: A cohort study," PLOS Medicine, Public Library of Science, vol. 15(5), pages 1-16, May.
    4. Maria T Sánchez-Santos & Marco Mesa-Frias & Minkyoung Choi & Eveline Nüesch & Angel Asunsolo-Del Barco & Antoinette Amuzu & George Davey Smith & Shah Ebrahim & David Prieto-Merino & Juan P Casas, 2013. "Area-Level Deprivation and Overall and Cause-Specific Mortality: 12 Years’ Observation on British Women and Systematic Review of Prospective Studies," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
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