Persistent financial adversity and cognitive aging: a life course investigation

The long-term effect of persistent financial adversity on cognitive aging remains unclear. We examined how sustained financial hardship across adulthood associates with midlife cognition, cognitive decline, and later-life brain health and whether impacts vary by sex, childhood socioeconomic circumstances (SECs), and genetic risk.

Using data from the 1946 British birth cohort (N = 2,759) and its neuroimaging sub-study, Insight 46 (N = 356-468), we linked financial adversity (low household income, financial hardships between ages 26 and 53) with cognitive performance at age 53, cognitive decline from ages 53 to 69, and neuroimaging measures at ages 69-71. We tested moderating roles of sex, childhood SEC, and APOE-ɛ4.

Increased exposure to low household income and financial hardships was associated with lower processing speed (-0.07 [-0.13, -0.02] and -0.05 [-0.11, -0.00]) and verbal memory at age 53 (-0.16 [-0.21, -0.11] and -0.10 [-0.15, -0.05]). This was followed by slower verbal memory decline, attributable to lower baseline scores. Persistent low income was associated with greater ventricular volume (b = 4.67 ml [1.01, 8.32]). Stronger associations between financial adversity and brain atrophy were found for male participants, those with lower childhood SEC, and APOE-ɛ4 carriers who were consistently more vulnerable.

Persistent financial adversity impacts cognitive performance by midlife and later-life brain atrophy, with larger effects for men, those from disadvantaged childhoods, and individuals with greater genetic risk. Supporting financially vulnerable working-age adults could help prevent dementia in an aging population.