LAUSR

We examined associations of individual- and neighborhood-level life course socioeconomic-status (LC-SES) with incident dementia in the Atherosclerosis Risk in Communities cohort. Individual- and neighborhood-level SES were assessed at three life epochs (childhood, young adulthood, midlife) via questionnaire (2001-02) and summarized into LC-SES scores. Dementia was ascertained through 2013 using cognitive exams, telephone interviews, and hospital and death certificate codes. Cox regression estimated hazard ratios (HR) of dementia by LC-SES scores in race-specific models. 12,599 participants (25% African American) with a mean age of 54 and median follow-up of 24 years were included in analyses. Each standard deviation greater individual LC-SES score was associated with a 14% (HR: 0.86 (0.81, 0.92)) lower risk of dementia in whites and 21% (HR: 0.79 (0.71, 0.87)) lower risk in African Americans. Education was removed from the individual LC-SES score and adjusted for separately to assess economic factors of LC-SES. A standard deviation greater individual LC-SES score without education was associated with a 10% (HR: 0.90 (0.84, 0.97)) lower dementia risk in whites and 15% (HR: 0.85 (0.76, 0.96)) lower risk in African Americans. Neighborhood LC-SES was not associated with dementia. Individual LC-SES is a risk factor for dementia, whereas neighborhood LC-SES was not associated.