Life Course Socioeconomic Position and Cognitive Aging in Later Life: Evidence and Models

Abstract Background Low socioeconomic position (SEP) throughout the life course is linked to poorer cognitive health in later life, but the life course models explaining this association remain debated. We conducted a scoping review to advance understanding. Methods We examined observational studies on the association between life course SEP and cognitive function in later life, considering cognition as both a cross-sectional level and a longitudinal trajectory across cognitive domains. We assessed whether the empirical evidence supported life course models. We included studies in the general population with cognition measured at age 45+. 42 studies (21 datasets representing 46 countries) were analysed. Results For cognitive level, studies consistently found associations between SEP at various stages of the life course and overall cognition level, as well as across specific cognitive domains. These associations were generally robust to confounding and mediating factors. For cognitive trajectory, associations with SEP across the life course and cognitive domains were inconclusive. Results supported the sensitive period, pathway, and accumulation models, but not the critical period model. Education was identified as a pathway and potential mediator in the association between early-life SEP and later-life cognition. Conclusions SEP throughout the life course has a robust association with later-life cognitive level, but not decline. Early-life cognitive enrichment for young people raised in socioeconomically disadvantaged households, or improving education, may reduce the SEP gap in cognitive functioning during later life. Key messages • Socioeconomic position throughout the life course is consistently associated with cognitive function levels in later life. • Improving education has the potential to cut the link between early-life SEP and cognitive function levels in later life.