Abstract
Dementia is a debilitating neurodegenerative syndrome characterized by deterioration in memory, cognitive, behavioral, and physical capacity. Recent research has indicated that some early-life social determinants of health (SDH), which vary by race/ethnicity may hold clues to the onset of dementia. Although early life clinical risk factors of dementia have been identified, early-life SDH such as education, sociodemographic and socioeconomic characteristics are yet to be collated. This review study focused on early-life (less than18 years of age) SDH in relation to cognitive decline in later life and differences across racial/ethnic groups in the U.S. A systematic review of articles in and after January of 1999 was conducted using Scoping Reviews - an approach for evidence synthesis to determine the coverage of a body of literature. Studies that report the impact of early-life social determinants on late-life cognitive decline were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed and Scopus databases. Our initial database search resulted in 823 studies, and of those, 102 studies satisfied the inclusion criteria. The systematic review identified the following risk factors: lower education (34%), lower socioeconomic status (25%), Adverse Childhood Experiences (ACEs) (14%), exposure to environmental toxins (11%), food insecurity (6.8%), and rural residence (4%). Although education and socioeconomic status are well-known risk factors of cognitive decline in later life, other understudied factors such as food insecurity and residing in rural areas are yet to be explored. Implications in terms of understanding the link between early life SDH and dementia in later life are discussed.
Social Determinants of Health And The Onset of Dementia in Later Life
