ArticleJournal of epidemiology and community health2023
Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study.
Article in Journal of epidemiology and community health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- A longitudinal study of socioeconomic status and cognitive function in middle-aged and older adults in China: random intercept cross-lagged panel analysis.Cognitive processing · 2026Article
- Association of educational attainment with mental disorders and the mediation role of lifestyle factors: a Mendelian randomization study.European archives of psychiatry and clinical neuroscience · 2026Article
- Employing the X-Learner Algorithm to Evaluate the Intervention Effects of Physical Activity on Determinants of Elderly Mental Health.Healthcare (Basel, Switzerland) · 2025Article
- The influence of social mobility perception and expectation on residents' health: the role of subjective well-being and physical exercise.Frontiers in public health · 2025Article
- Multimorbidity in patients with atrial fibrillation.Open heart · 2024Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLow socioeconomic status (SES) is associated with poor mental health and cognitive function. Individual-level SES and area-level SES (ASES) may affect mental health and cognitive function through lifestyle. We aimed to quantify the associations of ASES with mental health and cognitive function and examine the mediating role of lifestyle behaviours independent of individual-level SES in a Norwegian population.
methodsIn this cross-sectional study, we included 7211 participants (54% women) from the seventh survey of the Tromsø Study (2015-2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) from Statistics Norway at the geographical subdivision level. Tromsø7 data were used as mediators (smoking, snuff, alcohol, physical activity, diet) and outcomes (cognitive function, anxiety, depression, insomnia). Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex.
resultsHigher ASES was associated with better cognitive function and fewer depression and insomnia symptoms, independent of individual-level SES. These associations were mediated by smoking and physical activity. Alcohol was a mediator for depression and cognitive function in women. Age was a significant moderator of the association between ASES and global cognitive function in women. The largest total indirect effect of ASES was found for depression, with the joint effect of the mediators accounting for 36% of the total effect.
conclusionsPeople living in areas with lower ASES are at higher risk of poor mental health, such as depression and insomnia, and have lower cognitive function possibly due to unhealthy lifestyle (smoking, alcohol and physical inactivity).
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