Socioeconomic area deprivation and its relationship with dementia, Parkinson's Disease and all-cause mortality among UK older adults: a multistate modeling approach

May A. Beydoun, Michael F. Georgescu, Jordan Weiss, Nicole Noren Hooten, Hind A. Beydoun, Jack Tsai, Christian A. Maino Vieytes, Michele K. Evans and Alan B. Zonderman

Social Science & Medicine, 2025, vol. 379, issue C

Abstract: The study analyzed the association of area-level socioeconomic status (SES) with the risk of all-cause dementia, Parkinson's Disease (PD), and all-cause mortality using a multistate approach. Data from the UK Biobank were used (N = 363,663 50+y individuals, ≤15y follow-up), and Cox proportional hazards and multistate parametric models including Weibull regression were conducted, while cardiovascular health was tested as a potential mediator. In multistate models, socioeconomic area-level deprivation, measured by the Townsend Deprivation Index (TDI) z-score, was positively associated with the hazard of going from healthy into the 3 states of PD, dementia, and all-cause mortality (i.e. transitions 1: HR = 1.06, 95 % CI:1.02–1.10, P = 0.005, 2: HR = 1.19, 95 % CI: 1.16–1.22, P < 0.001 and 3: HR = 1.19, 95 % CI: 1.18–1.21, P < 0.001), with no association detected for transitions 4 (PD→Dementia), 5 (PD→Death), or 6 (Dementia→Death). Cardiovascular health did not mediate these associations. Socioeconomic area-level deprivation was directly associated with reduced survival rates from Healthy into Dementia, PD and Death.

Keywords: Socioeconomic status; Area deprivation; Dementia; Parkinson's disease; All-cause mortality; Multistate models; Aging (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1016/j.socscimed.2025.118137

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