ArticleBMJ open2020
Role of cumulative biological risk in mediating socioeconomic disparities in cognitive function in the elderly: a mediation analysis.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- Association between allostatic load and incident dementia, and race/ethnic disparities in the association in the U.S. health and retirement study.Psychoneuroendocrinology · 2026Article
- Disparities in Allostatic Load Among Different Races: A Comprehensive Scoping Review.Journal of racial and ethnic health disparities · 2025Review
- Racial Disparities in COVID-19 Severity Are Partially Mediated by Chronic Stress-Evidence from a Large Integrated Healthcare System.Journal of racial and ethnic health disparities · 2025Observational
- Biological Mechanisms Linking Social Adversity and Cognition.Public health reviews · 2025Review
- "Rest of the folks are tired and weary": The impact of historical lynchings on biological and cognitive health for older adults racialized as Black.Social science & medicine (1982) · 2025Article
- Inflammation, Cognition, and White Matter in Older Adults: An Examination by Race.Frontiers in aging neuroscience · 2020Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo evaluate whether allostatic load (AL), a measure of cumulative biological risk, fully or partially mediates observed socioeconomic status (SES) differences in cognitive function in the elderly.
designCross-sectional mediation analysis.
settingCommunity-dwelling US elderly who participated in the National Health and Nutrition Examination Survey (NHANES).
participantsThe NHANES uses a complex, multistage, probability sampling design to select a nationally representative sample. Of the 4976 elderly (60 years or older) who were selected, 3234 agreed to participate in the household and medical exam interviews (65% response rate). PRIMARY AND SECONDARY OUTCOME MEASURES: Performance on the Digit Symbol Substitution Test (DSST)-a measure of cognitive function.
resultsRelative to participants with the lowest level of education or family income, participants who were college graduates (β=24.4, 95% CI 22 to 26.8, p<0.0001) or in the highest income quartile (β=17.3, 95% CI 15.2 to 19.4, p<0.0001) had the highest DSST scores and the least AL burden (β=-0.72, 95% CI -0.98 to -0.47 and β=-0.82, 95% CI -1 to -0.57; p<0.0001, respectively). Although, AL was significantly negatively associated with cognitive performance (β = -1, 95% CI -1.4 to -0.5, p<0.0001), it mediated at most 4.5% of the SES effect on DSST performance.
conclusionsThe findings suggest that AL, as measured by a summary index of parameters for cardiovascular function, metabolism and chronic inflammation, is not a significant mediator of SES-related differences in cognitive function in the elderly. Further efforts are required to elucidate the exact physiological pathways and mechanisms through which SES impacts cognitive function in late life.
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