Background: Subjective social status (SSS) is associated with mental and physical health, independent of objective socioeconomic status (SES), but its association with late-life cognitive decline is unknown. Objective: This study characterizes the association between SSS and late-life memory trajectories in a large, nationally representative sample of older adults in the United States. Methods: Using data from 8,530 participants aged 65 years and older in the Health and Retirement Study, structural equation models tested associations between SSS, objective SES (i.e., educational attainment, occupation, income, and wealth), physical and mental health, and 6-year memory trajectories, controlling for sociodemographic characteristics. Results: Independent of objective SES, lower SSS was associated with worse initial memory but not subsequent memory decline. The association between SSS and initial memory was separately mediated by chronic diseases, stroke, and depressive symptoms. Conclusion: Results provide preliminary behavioral evidence for the deleterious effects of social stress on cognitive aging. These results may help inform the development of policies and interventions to reduce cognitive morbidity among older adults who perceive a low position on the social hierarchy.

Keywords:
Cognition, Cognitive decline, Depression
1.
Adler NE, Ostrove JM: Socioeconomic status and health: what we know and what we don’t. Ann NY Acad Sci 1999; 896: 3–15.
2.
Link BG, Phelan J: Social conditions as fundamental causes of disease. J Health Soc Behav 1995;(Spec No): 80–94.
3.
Phelan JC, Link BG, Tehranifar P: Social conditions as fundamental causes of health inequalities: theory, evidence, and policy im-plications. J Health Soc Behav 2010; 51 (suppl):S28–S40.
4.
Zahodne LB, Stern Y, Manly JJ: Differing effects of education on cognitive decline in diverse elders with low versus high educational attainment. Neuropsychology 2015; 29: 649–657.
5.
Marden JR, Tchetgen Tchetgen EJ, Kawaachi I, Glymour MM: Contribution of socioeconomic status at 3 life-course periods to late-life memory function and decline: early and late predictors of dementia risk. Am J Epidemiol 2017; 186: 805–814.
6.
Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y: Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health 2014; 14: 643.
7.
Wilkinson RG: Health, hierarchy, and social anxiety. Ann NY Acad Sci 1999; 896: 48–63.
8.
Euteneuer F: Subjective social status and health. Curr Opin Psychiatry 2014; 27: 337–343.
9.
Singh-Manoux A, Marmot MG, Adler NE: Does subjective social status predict health and change in health status better than objective status? Psychosom Med 2005; 67: 855–861.
10.
Miyakawa M, Magnusson Hanson LL, Theorell T, Westerlund H: Subjective social status: its determinants and association with health in the Swedish working population (the SLOSH study). Eur J Public Health 2012; 22: 593–597.
11.
Molina KM, Alegria M, Mahalingam R: A multiple-group path analysis of the role of everyday discrimination on self-rated physical health among Latina/os in the USA. Ann Behav Med 2013; 45: 33–44.
12.
Macinko J, Mullachery P, Proietti FA, Lima-Costa MF: Who experiences discrimination in Brazil? Evidence from a large metropolitan region. Int J Equity Health 2012; 11: 80.
13.
Adler NE, Epel ES, Castellazzo G, Ickovics JR: Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol 2000; 19: 586–592.
14.
Singh-Manoux A, Macleod J, Davey S: Psychosocial factors and public health. J Epidemiol Community Health 2003; 57: 553–556.
15.
McNaull BB, Todd S, McGuinness B, Passmore AP: Inflammatory and anti-inflammatory strategies for Alzheimer’s disease – a mini-review. Gerontology 2010; 56: 3–14.
16.
Neugroschl J, Davis KL: Biological markers in Alzheimer’s disease. Am J Geriatr Psychiatry 2002; 10: 660–677.
17.
Diaz V, Guendelman S, Kuppermann M: Subjective social status and depressive symptoms: a prospective study of women with noncancerous pelvic problems. Womens Health Issues 2014; 24: 649–655.
18.
Gianaros PJ, Horenstein JA, Cohen S, Matthews KA, et al: Perigenual anterior cingulate morphology covaries with perceived social standing. Soc Cogn Affect Neurosci 2007; 2: 161–173.
19.
Chen Y, Denny KG, Harvey D, Farias ST, et al: Progression from normal cognition to mild cognitive impairment in diverse clinic-based and community-based elderly cohort. Alz-heimers Dement 2017; 13: 399–405.
20.
Mourao RJ, Mansur G, Malloy-Diniz LF, Castro Costa E, Diniz BS: Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and meta-analysis. Int J Geriatr Psychiatry 2016; 31: 905–911.
21.
Ursache A, Noble KG, Blair C: Socioeconomic status, subjective social status, and perceived stress: associations with stress physiology and executive functioning. J Behav Med 2015; 41: 145–154.
22.
Cené CW, Halladay JR, Gizlice Z, Roeders-heimer K, Hinderliter A, Cummings DM, et al: Associations between subjective social status and physical and mental health functioning among patients with hypertension. J Epidemiol 2016; 43: 576–585.
23.
Sonnega A, Weir DR: The Health and Retirement Study: a public data resource for research on aging. Open Health Data 2014; 2:e7.
24.
Bäckman L, Small BJ, Fratiglioni L: Stability of the preclinical episodic memory deficit in Alzheimer’s disease. Brain 2001; 124(Pt1): 96–102.
25.
Gueorguieva R, Sindelar JL, Falba TA, Fletcher JM, et al: The impact of occupation on self-rated health: cross-sectional and longitudinal evidence from the Health and Retirement Survey. J Gerontol B Psychol Sci Soc Sci 2009; 64B: 118–124.
26.
Cundiff JM, Smith TW, Uchino BN, Berg CA: Subjective social status: construct validity and associations with psychosocial vulnerability and self-rated health. Int J Behav Med 2013; 20: 148–158.
27.
Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385–401.
28.
Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 1999; 6: 1–55.
29.
Taylor SE, Seeman TE: Psychosocial resources and the SES-health relationship. Ann NY Acad Sci 1999; 896: 210–225.
30.
Scott KM, Al-Hamzawi AO, Andrade LH, Borges G, Caldas-de-Almeida JM, Fiestas F, et al: Associations between subjective social status and DSM-IV mental disorders: results from the World Mental Health surveys. JAMA Psychiatry 2014; 71: 1400–1408.
31.
Hoebel J, Maske UE, Zeeb H, Lampert T: Social inequalities and depressive symptoms in adults: the role of objective and subjective socioeconomic status. PLoS One 2017; 12: e0169764.
32.
Schubert T, Süssenbach P, Schäfer SJ, Eu-teneuer F: The effect of subjective social status on depressive thinking: an experimental examination. Psychiatry Res 2016; 241: 22–25.
33.
Euteneuer F, Mills PJ, Rief W, Ziegler MG, Dimsdale JE: Subjective social status predicts in vivo responsiveness of beta adrenergic receptors. Health Psychol 2012; 31: 525–529.
34.
Manuck SB, Phillips J, Gianaros PJ, Flory JD, Muldoon MF: Subjective socioeconomic status and presence of metabolic syndrome in midlife community volunteers. Psychosom Med 2010; 72: 35–45.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.