Social participation and cognitive activities as explanation factor for the association between income and self-rated health for older adults

Front Public Health. 2024 Nov 28:12:1435945. doi: 10.3389/fpubh.2024.1435945. eCollection 2024.

Abstract

Introduction: Health disparities pose a considerable challenge for older adults individuals, particularly those with a heightened risk of developing dementia. Discrepancies in health status among various income brackets are only partially attributable to structural factors such as working and living conditions or the quality of food. The aim of this study was therefore to explore whether and to what extent various health-promoting behaviors can explain the association between household income and self-rated health among older people at risk of dementia.

Methods: The sample consisted of 845 participants (average age 68.9 years; 52.6% female) from the AgeWell.de study, an intervention trial aiming to preserve cognitive function. The participants exhibited an increased risk of dementia, defined by a CAIDE (Cardiovascular Risk Factors, Aging and Dementia) score of at least nine points. To explore the relationship between household income and self-rated health, measured using the EQ-5D-VAS, a regression analysis was conducted. This association was then examined using four mediation analyses that included health-promoting behaviors such as fruit and vegetable consumption, social participation, physical activities, and cognitive activities.

Results: The results reveal a positive association between higher income and self-rated health. This relationship is mediated by social participation. Additionally, cognitive activities were found to partially mediate this correlation. Neither physical activities nor fruit and vegetable consumption could account for the association between income and self-rated health.

Conclusion: The findings have the potential to advance research on the correlation between income and health among older age cohorts at risk of developing dementia. They highlight the potential significance of social engagement and cognitive activities for health and may inspire the development of strategies aimed at enhancing accessibility to activities such as cultural events, educational institutions, and participation in courses for a wider audience.

Keywords: cognitive activities; fruit and vegetable consumption; higher age groups; income; physical activities; self-rated health; social participation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition*
  • Dementia
  • Exercise
  • Female
  • Health Status
  • Humans
  • Income* / statistics & numerical data
  • Male
  • Middle Aged
  • Social Participation*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This publication is part of the study “AgeWell.de -a multi-centric cluster-randomized controlled prevention trial in primary care” and was funded by the German Federal Ministry for Education and Research (BMBF; grants: 01GL1704A, 01GL1704B, 01GL1704C, 01GL1704D, 01GL1704E, 01GL1704F). The BMBF had no role in the design of this study and has no role during its execution, analyses, interpretation of the data, or decision to submit results. Open Access funding enabled and organized by the Open Access Publishing Fund of Leipzig University supported by the German Research Foundation within the program Open Access Publication Funding.