Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects

Abstract

Background Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. Methods We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. Results Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. Conclusions Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.

Factors leading to the trajectory of cognitive decline in middle-aged and older adults using group-based trajectory modeling: A cohort study

“…A collaboration network in Latin American evaluated the socioeconomic status of 1175 participants, which uncovered that subjects with a lower income were more related to cognition decline. [21] In the present paper, we also found that in middle aged and older people, a lower income may lead to a decreased cognitive function. People with improved sleep duration may have a better cognitive function, [22] but a cohort study in the Doetinchem also revealed that middle-aged people who had too long sleep duration may also result in a lower cognitive function.…”

The Relationship Between Socioeconomic Status and Risk of Schizophrenia

“…Education, income, and occupational status are positively associated with disease identification and realistic estimates of lifetime prevalence of depression. Social status with higher education provides a modest protection against schizophrenia [14]. In addition, the SES factors of education, parental education, and income were more related to cognition in patients than in common people.…”

Cognitive reserve moderates the relationship between childhood maltreatment, objective and subjective cognition, and psychosocial functioning in individuals with first-episode psychosis.

“…A social desirability score was computed using the sum of the responses to three items (10, 16, 22) of the CTQ-SF minimization-denial subscale (Church et al, 2017). Given the extensive literature linking psychotic disorder to social and economic disadvantage and poor cognitive (Czepielewski et al, 2022; Husain et al, 2018) and psychosocial functioning (Izquierdo et al, 2021), parental SES (Hollingshead & Redlich, 2007) was also considered as a covariate.…”