Education, Wealth and Job Status Affect your Dementia Odds; Study

By Oluwasola Samuel, Freelance Health writer. With medical review by the DLHA Team.

Senior African couple. Image credit:Freepik

Did you know that factors like education, job type, and wealth can affect your odds of higher order brain function (cognitive) impairment, including dementia? 

It may seem surprising, but recent research from the University College London (UCL) highlights how these socioeconomic factors help in limiting your chances of developing dementia and also determining your chances of improving if impairment has already begun.

“Our study highlights the critical role of wealth, education, and occupation not only in reducing the risk of transitioning from mild cognitive impairment to dementia but also in increasing the likelihood of reversing cognitive impairment to a healthy cognitive state, which is promising,” said Dorina Cadar, a senior investigator and an honorary senior research fellow in dementia with the University College London’s (UCL) Department of Behavioural Science and Health.

This research highlights new possibilities for improving cognitive health across all economic backgrounds and gives us much to think about in terms of how society can better support those at risk. 

For Africans and other communities where access to higher education and wealth may be limited, this study sheds light on the important ways you can protect your cognitive health.

Let’s dive in to know more about this recent research and what it might mean for Africans.

About the study

For the study, the researchers observed 8,442 adults in England who were 50 years and older and collected data on each participant’s education, job type, and financial status at the beginning of the study. 

Over a period of ten years (2008 to 2018), the researchers tracked transitions in participants’ cognitive health, i.e., how they moved forwards and in reverse through three main states of higher order brain function; i.e., healthy, mild impairment, and dementia. They also examined how certain socioeconomic factors influenced these transitions using self-reporting questionnaires that included participants' reports of a doctor’s diagnosis, cognitive test results, and their own reports of symptoms and complaints, thus providing a full picture of each participant’s cognitive health. In addition, the study also accounted for participants’ characteristics or demographic factors, such as age, sex, and marital status. 

The study made some surprising observations that are summarised below.

What the study found

Below are the main findings of the study in facts and figures:

• People with higher education, better-paying jobs, and greater wealth were less likely to move from a healthy cognitive state to mild cognitive impairment or from mild impairment to dementia compared to those with no higher than secondary school education who work in manual or routine occupations, and are in the low income category.

• Adults with a university education had a 43% lower chance of developing mild cognitive impairment compared to those with only primary or secondary education.

• The wealthiest third of participants were 26% less likely to move from mild cognitive impairment to dementia than those in the lowest third.

• People from wealthier backgrounds were 56% more likely to recover from mild cognitive impairment and return to a healthy state. 

• Those with higher education and mentally stimulating jobs had an even higher chance of 81% in improving or reversing mild cognitive impairment compared to adults with lesser qualities.

“This potential recovery is critical for enhancing the quality of life in later years and reducing the long-term burden of cognitive impairment on healthcare systems, families, and society as a whole,” Cadar added.

The study did not exactly provide cause-effect explanations for how education and wealth influence cognitive health. However, the researchers believe there may be several strong connections.

“It is possible that education and intellectually demanding jobs provide more mental stimulation and help to build a stronger brain reserve to help protect individuals against cognitive impairment and dementia.” said Aswathikutty Gireeshl, lead author and PhD candidate with the University College London.

“Additionally, people with higher education, more intellectually demanding jobs, and wealth have better access to healthcare and health-promoting resources such as a nutritious diet, exercise, and preventive care—all of which can support cognitive health. These resources could also offer opportunities to stabilise or improve cognitive function, especially when cognitive impairment is detected early.” Gireesh added.

Lessons Africans can learn from the study

For many in sub-Saharan Africa, resources like wealth, quality education, and fulfilling jobs can be a luxury.  However, the study provides valuable lessons, especially as cognitive health issues like dementia are on the rise in various countries on the continent. 

With predominant high poverty rates, limited access to healthcare and quality education, it may feel challenging for many Africans to protect their brain health. However, the research provides interesting and useful insights on what could be done to change the narrative in low-income countries like in sub-Saharan Africa.

Here are some valuable insights from the study for African policy makers and public health managers to consider:

• Invest in Education: African governments and other stakeholders should invest more in education, as it is an essential step in building and strengthening cognitive ability. Education doesn’t always mean formal schooling. Lifelong learning, engaging in mentally challenging activities, reading, or even picking up new skills can help strengthen cognitive reserve and flexibility. Governments and communities can work together to provide accessible formal and vocational educational programs that support brain health.

• Promote financial inclusion and wealth creation initiatives: Financial stability isn’t easy to achieve for many, but even small steps like financial education and skills training programs for low-income families, when coupled with small grants-in-aid, can improve their financial status and make a difference. In addition, empowerment programs and initiatives that provide subsidies for food, safe housing, and affordable healthcare can help improve the standard of living of populations, which can contribute positively to healthier minds.

• Support job creation initiative and programs for mental stimulation in communities: Due to the high rate of unemployment in Africa, many may not be privileged to have professional jobs that are mentally demanding. However, initiatives like local or community activities, volunteer programs, or even support group discussion and actions to address local issues should be encouraged as these provide mental stimulation for problem solving. Also, brain-tasking activities like reading (in local or whatever languages), solving puzzles, and learning new skills should be encouraged among individuals. These activities can help to strengthen mental resilience, even in those without a formal education or wealth.

• Provide support for dementia screening in primary care settings: As the study has shown, early detection of cognitive impairment with intervention well before dementia sets in, provides the best outcome. So, low-cost dementia screening in primary care facilities that are tailored to local cultures, would be a beneficial addition to the promotive care of locals from age 50 and above.  

Wrap up

Dementia remains a complex and rising condition in Africa. The study highlights the kind of environment that supports brain health. The fact that education, wealth, and occupation can affect cognitive impairment and even reverse mild cases is encouraging. There are powerful lessons for Africans to learn from the study. 

Governments and other public policy stakeholders in sub-Saharan Africa should improve investment in quality education (formal and vocational), implement fair and inclusive economic policies for sustainable job and wealth creation. They should also promote regular screening for brain health status among other health priorities, in appropriately funded and staffed primary care facilities. Such a mix of inclusive policy steps would help improve the lives of everyone and more especially those of low income families. It would grow an inclusive and healthy society, where the scourge of dementia (severe brain health impairment) can be reasonably controlled.

Source:

Gireesh, A., Sacker, A., McMunn, A. et al. Socioeconomic inequalities linked to the transitioning to neurocognitive disorders and mortality. Sci Rep 14, 24690 (2024). Doi: 10.1038/s41598-024-74125-w. Available from here.

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Published: November 23, 2024

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