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70/100

✓ Peer-reviewed alzhub usefulness score 70 out of 100. Prevention and risk

Reviewed as evidence on: Income support / cash transfers and memory decline, dementia risk 1 study (what the news said). Being listed means the study bears on the question, not that it agrees with the news.

Topic: Risk, prevention and care in population studies

Background Differences in dementia risk across the gradient of socioeconomic status (SES) exist, but their determinants are not well understood. Objective This study investigates whether health conditions and lifestyle-related risk factors explain the SES inequalities in dementia risk. Methods 6,346 participants from the English Longitudinal Study of Ageing were followed up from 2008/2009 until 2014/2015. We used Cox regression adjusted for age, gender, wealth/education, and clustering at the household level to examine the association between SES markers (wealth, education) and time to dementia in a structural equation model including potential mediation or effect modification by a weighted compound score of twelve modifiable risk and protective factors for dementia ('LIfestyle for BRAin health' (LIBRA) score). Results During a median follow-up of 6 years, 192 individuals (3.0%) developed dementia. LIBRA scores decreased with increasing wealth and higher educational level. A one-point increase in the LIBRA score was associated with a 13% increase in dementia risk (hazard ratio (HR) = 1.13, 95% confidence interval 1.07-1.19). Higher wealth was associated with a decreased dementia risk (HR = 0.58, 0.39-0.85). Mediation analysis showed that 52% of the risk difference between the highest and lowest wealth tertile was mediated by differences in LIBRA (indirect effect: HR = 0.75, 0.66-0.85). Education was not directly associated with dementia (HR = 1.05, 0.69-1.59), but was a distal risk factor for dementia by explaining differences in wealth and LIBRA scores (indirect effect high education: HR = 0.92, 0.88-0.95). Conclusion Socioeconomic differences in dementia risk can be partly explained by differences in modifiable health conditions and lifestyle factors.

Key findings

Results During a median follow-up of 6 years, 192 individuals (3.0%) developed dementia.
A one-point increase in the LIBRA score was associated with a 13% increase in dementia risk (hazard ratio (HR) = 1.13, 95% confidence interval 1.07-1.19).
Higher wealth was associated with a decreased dementia risk (HR = 0.58, 0.39-0.85).
Mediation analysis showed that 52% of the risk difference between the highest and lowest wealth tertile was mediated by differences in LIBRA (indirect effect: HR = 0.75, 0.66-0.85).
Education was not directly associated with dementia (HR = 1.05, 0.69-1.59), but was a distal risk factor for dementia by explaining differences in wealth and LIBRA scores (indirect effect high education: HR = 0.92, 0.88-0.95).

Why it matters

Among 6,346 older adults in the English Longitudinal Study of Ageing followed for a median of 6 years, wealthier people had lower dementia risk (HR 0.58). The study estimated that 52% of the risk difference between the highest and lowest wealth tertiles ran through differences in a score of twelve modifiable health and lifestyle factors (LIBRA). Education had no direct link but worked indirectly through wealth and LIBRA, and the authors conclude only that such factors "partly" explain socioeconomic differences, which is an association, not evidence that changing them prevents dementia.

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Study details

Study designlongitudinal study
Participants6,346
Effect size3.0%; HR = 0.58; HR = 0.75
Evidence strengthModerate

How this study scored 70/100

Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of Alzheimer's disease : JAD)
Journal's citation record	2 / 4	Journal of Alzheimer s Disease: journal h-index 218 (OpenAlex, 2026-10-29)
Study design	7 / 12	A longitudinal study following the same people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2019 — within 10 year(s) of the newest study here
Sample size	3 / 4	6,346 participants
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 182 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	20.2 citations a year over 9 year(s) since 2019
Impact for its field and year	4 / 6	Cited 9.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 11 other studies in this library
Still being cited	3 / 4	Cited 97 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Sebastian Köhler: h-index 56 (OpenAlex, whole career)
Institution's track record	2 / 3	University College London: institution h-index 2,029 (OpenAlex)
Multi-centre collaboration	2 / 3	PubMed indexes it as a multicentre study
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 31424404)
Free to read	2 / 2	Free to read
Total	70 / 100	—

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Cite this study APA, Vancouver, BibTeX · download .bib or .ris

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APA 7th

Deckers, K., Cadar, D., van Boxtel, M. P. J., Verhey, F. R. J., Steptoe, A., & Köhler, S. (2019). Modifiable Risk Factors Explain Socioeconomic Inequalities in Dementia Risk: Evidence from a Population-Based Prospective Cohort Study. Journal of Alzheimer's disease : JAD. https://doi.org/10.3233/jad-190541

Vancouver

Deckers K, Cadar D, van Boxtel MPJ, Verhey FRJ, Steptoe A, Köhler S. Modifiable Risk Factors Explain Socioeconomic Inequalities in Dementia Risk: Evidence from a Population-Based Prospective Cohort Study. Journal of Alzheimer's disease : JAD. 2019. doi:10.3233/jad-190541. PMID: 31424404.

BibTeX

@article{deckers2019-31424404,
  author  = {Deckers, K. and Cadar, D. and van Boxtel, M. P. J. and Verhey, F. R. J. and Steptoe, A. and Köhler, S.},
  title   = {{Modifiable Risk Factors Explain Socioeconomic Inequalities in Dementia Risk: Evidence from a Population-Based Prospective Cohort Study}},
  journal = {Journal of Alzheimer's disease : JAD},
  year    = {2019},
  doi     = {10.3233/jad-190541},
  pmid    = {31424404},
  url     = {https://doi.org/10.3233/jad-190541}
}

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