Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.

<h4>Background</h4>The global older population is increasing, leading to a rise in non-communicable diseases and disabilities, particularly in Western countries. With the aging population expanding and the number of older adults with cognitive impairments expected to rise, there is incre...

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Main Authors: Omar Hahad, Jasmin Ghaemi Kerahrodi, Isabel Heinrich, Katharina Geschke, Katja Petrowski, Elmar Brähler, Julia Petersen, Anna C Reinwarth, Julian Chalabi, Alexander K Schuster, Emilio Gianicolo, Karl Lackner, Peter R Galle, Stavros Konstantinides, Sadeer Al-Kindi, Philipp Wild, Oliver Tüscher, Matthias Michal, Manfred E Beutel
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0328988
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author Omar Hahad
Jasmin Ghaemi Kerahrodi
Isabel Heinrich
Katharina Geschke
Katja Petrowski
Elmar Brähler
Julia Petersen
Anna C Reinwarth
Julian Chalabi
Alexander K Schuster
Emilio Gianicolo
Karl Lackner
Peter R Galle
Stavros Konstantinides
Sadeer Al-Kindi
Philipp Wild
Oliver Tüscher
Matthias Michal
Manfred E Beutel
author_facet Omar Hahad
Jasmin Ghaemi Kerahrodi
Isabel Heinrich
Katharina Geschke
Katja Petrowski
Elmar Brähler
Julia Petersen
Anna C Reinwarth
Julian Chalabi
Alexander K Schuster
Emilio Gianicolo
Karl Lackner
Peter R Galle
Stavros Konstantinides
Sadeer Al-Kindi
Philipp Wild
Oliver Tüscher
Matthias Michal
Manfred E Beutel
author_sort Omar Hahad
collection DOAJ
description <h4>Background</h4>The global older population is increasing, leading to a rise in non-communicable diseases and disabilities, particularly in Western countries. With the aging population expanding and the number of older adults with cognitive impairments expected to rise, there is increasing interest in understanding the socioeconomic disparities associated with cognitive impairment. This study investigates the relationships between socioeconomic status (SES), cognitive impairment, quality of life, and mortality among older adults in Germany.<h4>Methods</h4>Data from the senior cohort (N = 1,069) of the German Gutenberg Health Study (2017-2024) were analyzed, focusing on older adults aged 75-85 years. Regression modeling with sequential adjustment for covariates was employed to determine the association between various domains of SES (SES index comprising educational background, occupational status, and household net-income) and cognitive impairment (Montreal Cognitive Assessment), quality of life (EUROHIS-QOL), and all-cause mortality.<h4>Results</h4>Cognitive impairment scores varied significantly by SES with higher SES being associated with better cognitive performance. Among the SES domains, the household net-income score was the strongest predictor of cognitive impairment. Likewise, higher SES was significantly associated with higher quality of life, whereas no association between cognitive impairment and quality of life was found. Additionally, cognitive impairment was significantly associated with higher all-cause mortality, whereas SES did not show a significant association with mortality. No significant interactions between SES and cognitive impairment were observed in relation to quality of life or all-cause mortality.<h4>Conclusion</h4>Among older adults, SES is strongly associated with cognitive impairment. However, cognitive impairment emerges as a more significant risk factor for all-cause mortality than SES. These findings suggest the need for public health strategies to prioritize cognitive health monitoring and targeted interventions, while simultaneously addressing social inequalities, to reduce the burden of these adverse outcomes.
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spelling doaj-art-4e5e16d1c3754757a5dc4cdeae4188542025-08-20T03:42:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032898810.1371/journal.pone.0328988Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.Omar HahadJasmin Ghaemi KerahrodiIsabel HeinrichKatharina GeschkeKatja PetrowskiElmar BrählerJulia PetersenAnna C ReinwarthJulian ChalabiAlexander K SchusterEmilio GianicoloKarl LacknerPeter R GalleStavros KonstantinidesSadeer Al-KindiPhilipp WildOliver TüscherMatthias MichalManfred E Beutel<h4>Background</h4>The global older population is increasing, leading to a rise in non-communicable diseases and disabilities, particularly in Western countries. With the aging population expanding and the number of older adults with cognitive impairments expected to rise, there is increasing interest in understanding the socioeconomic disparities associated with cognitive impairment. This study investigates the relationships between socioeconomic status (SES), cognitive impairment, quality of life, and mortality among older adults in Germany.<h4>Methods</h4>Data from the senior cohort (N = 1,069) of the German Gutenberg Health Study (2017-2024) were analyzed, focusing on older adults aged 75-85 years. Regression modeling with sequential adjustment for covariates was employed to determine the association between various domains of SES (SES index comprising educational background, occupational status, and household net-income) and cognitive impairment (Montreal Cognitive Assessment), quality of life (EUROHIS-QOL), and all-cause mortality.<h4>Results</h4>Cognitive impairment scores varied significantly by SES with higher SES being associated with better cognitive performance. Among the SES domains, the household net-income score was the strongest predictor of cognitive impairment. Likewise, higher SES was significantly associated with higher quality of life, whereas no association between cognitive impairment and quality of life was found. Additionally, cognitive impairment was significantly associated with higher all-cause mortality, whereas SES did not show a significant association with mortality. No significant interactions between SES and cognitive impairment were observed in relation to quality of life or all-cause mortality.<h4>Conclusion</h4>Among older adults, SES is strongly associated with cognitive impairment. However, cognitive impairment emerges as a more significant risk factor for all-cause mortality than SES. These findings suggest the need for public health strategies to prioritize cognitive health monitoring and targeted interventions, while simultaneously addressing social inequalities, to reduce the burden of these adverse outcomes.https://doi.org/10.1371/journal.pone.0328988
spellingShingle Omar Hahad
Jasmin Ghaemi Kerahrodi
Isabel Heinrich
Katharina Geschke
Katja Petrowski
Elmar Brähler
Julia Petersen
Anna C Reinwarth
Julian Chalabi
Alexander K Schuster
Emilio Gianicolo
Karl Lackner
Peter R Galle
Stavros Konstantinides
Sadeer Al-Kindi
Philipp Wild
Oliver Tüscher
Matthias Michal
Manfred E Beutel
Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.
PLoS ONE
title Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.
title_full Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.
title_fullStr Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.
title_full_unstemmed Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.
title_short Socioeconomic disparities in cognitive impairment, quality of life, and mortality among older adults in Germany.
title_sort socioeconomic disparities in cognitive impairment quality of life and mortality among older adults in germany
url https://doi.org/10.1371/journal.pone.0328988
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