Social determinants of modifiable health and lifestyle factors for brain health: who’s at risk?

Purpose For targeted dementia prevention programs, it is important to understand in which groups of people dementia risk factor load is high. To this end, we investigated social determinants of modifiable health and lifestyle factors for brain health in a large adult population.

Method The “LIfestyle for BRAin health” (LIBRA) score was computed for 6,203 baseline participants of the LIFE-Adult-Study. LIBRA is a validated dementia risk prediction score based on 12 modifiable health and lifestyle factors (e.g. heart disease, diabetes, obesity, hypertension, physical inactivity). Scores were split in tertiles to indicate low, middle or high dementia risk factor load. Associations of sociodemographic and socioeconomic variables with LIBRA tertiles were inspected using multinominal logistic regression analysis. Z-standardization and sampling weights were applied.

Results Participants were M = 57.7 (SD = 12.0; range: 40–79) years old and dementia-free; 50.7% were women. Individuals in the high LIBRA tertile had lower education, more often low SES, were less often married/in a partnership, more often unemployed and socially isolated compared to individuals in the middle and low LIBRA tertile. Individuals with low SES were 9-times (relative risk ratio/RRR = 9.0, 95%CI = 6.9-11.7) and individuals with middle SES 3-times (RRR = 3.0, 95%CI = 2.5-3.5) more likely in the high LIBRA tertile than individuals with high SES (ref.). High LIBRA tertile was furthermore associated with unemployment, not being married/in a partnership and social isolation.

Conclusion SES is a notably strong determinant of modifiable health and lifestyle factors for brain health. Individuals with low SES constitute a vulnerable risk group for ill-health and lifestyle behaviors known to drive dementia risk. Especially they should be targeted through dementia prevention programs.

Publication History

Article published online:
02 September 2021