Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study
Introduction - Low socioeconomic status (SES) is associated with poor mental health and cognitive function. Individual-level SES and area-level SES (ASES) may affect mental health and cognitive function through lifestyle. We aimed to quantify the associations of ASES with mental health and cognitive...
Published in: | Journal of Epidemiology and Community Health |
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ftunivtroemsoe:oai:munin.uit.no:10037/32263 2024-01-28T10:09:33+01:00 Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Grimsgaard, Anne Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa 2023-11-22 https://hdl.handle.net/10037/32263 https://doi.org/10.1136/jech-2023-220928 eng eng BMJ Publishing Group Journal of Epidemiology and Community Health Norges forskningsråd: 289440 Tiwari, Cerin, Wilsgaard, Løvsletten, Grimsgaard, Hopstock, Schirmer, Rosengren, Kristoffersen, Løchen. Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study. Journal of Epidemiology and Community Health. 2023 FRIDAID 2202404 doi:10.1136/jech-2023-220928 0143-005X 1470-2738 https://hdl.handle.net/10037/32263 Attribution 4.0 International (CC BY 4.0) openAccess Copyright 2023 The Author(s) https://creativecommons.org/licenses/by/4.0 Journal article Tidsskriftartikkel Peer reviewed publishedVersion 2023 ftunivtroemsoe https://doi.org/10.1136/jech-2023-220928 2024-01-04T00:08:06Z Introduction - Low socioeconomic status (SES) is associated with poor mental health and cognitive function. Individual-level SES and area-level SES (ASES) may affect mental health and cognitive function through lifestyle. We aimed to quantify the associations of ASES with mental health and cognitive function and examine the mediating role of lifestyle behaviours independent of individual-level SES in a Norwegian population. Methods - In this cross-sectional study, we included 7211 participants (54% women) from the seventh survey of the Tromsø Study (2015–2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) from Statistics Norway at the geographical subdivision level. Tromsø7 data were used as mediators (smoking, snuff, alcohol, physical activity, diet) and outcomes (cognitive function, anxiety, depression, insomnia). Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results - Higher ASES was associated with better cognitive function and fewer depression and insomnia symptoms, independent of individual-level SES. These associations were mediated by smoking and physical activity. Alcohol was a mediator for depression and cognitive function in women. Age was a significant moderator of the association between ASES and global cognitive function in women. The largest total indirect effect of ASES was found for depression, with the joint effect of the mediators accounting for 36% of the total effect. Conclusions - People living in areas with lower ASES are at higher risk of poor mental health, such as depression and insomnia, and have lower cognitive function possibly due to unhealthy lifestyle (smoking, alcohol and physical inactivity). Article in Journal/Newspaper Tromsø University of Tromsø: Munin Open Research Archive Norway Tromsø Journal of Epidemiology and Community Health 78 2 88 97 |
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Open Polar |
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University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
description |
Introduction - Low socioeconomic status (SES) is associated with poor mental health and cognitive function. Individual-level SES and area-level SES (ASES) may affect mental health and cognitive function through lifestyle. We aimed to quantify the associations of ASES with mental health and cognitive function and examine the mediating role of lifestyle behaviours independent of individual-level SES in a Norwegian population. Methods - In this cross-sectional study, we included 7211 participants (54% women) from the seventh survey of the Tromsø Study (2015–2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) from Statistics Norway at the geographical subdivision level. Tromsø7 data were used as mediators (smoking, snuff, alcohol, physical activity, diet) and outcomes (cognitive function, anxiety, depression, insomnia). Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results - Higher ASES was associated with better cognitive function and fewer depression and insomnia symptoms, independent of individual-level SES. These associations were mediated by smoking and physical activity. Alcohol was a mediator for depression and cognitive function in women. Age was a significant moderator of the association between ASES and global cognitive function in women. The largest total indirect effect of ASES was found for depression, with the joint effect of the mediators accounting for 36% of the total effect. Conclusions - People living in areas with lower ASES are at higher risk of poor mental health, such as depression and insomnia, and have lower cognitive function possibly due to unhealthy lifestyle (smoking, alcohol and physical inactivity). |
format |
Article in Journal/Newspaper |
author |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Grimsgaard, Anne Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa |
spellingShingle |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Grimsgaard, Anne Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study |
author_facet |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Grimsgaard, Anne Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa |
author_sort |
Tiwari, Sweta |
title |
Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study |
title_short |
Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study |
title_full |
Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study |
title_fullStr |
Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study |
title_full_unstemmed |
Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study |
title_sort |
lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the tromsø study |
publisher |
BMJ Publishing Group |
publishDate |
2023 |
url |
https://hdl.handle.net/10037/32263 https://doi.org/10.1136/jech-2023-220928 |
geographic |
Norway Tromsø |
geographic_facet |
Norway Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
Journal of Epidemiology and Community Health Norges forskningsråd: 289440 Tiwari, Cerin, Wilsgaard, Løvsletten, Grimsgaard, Hopstock, Schirmer, Rosengren, Kristoffersen, Løchen. Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: the Tromsø Study. Journal of Epidemiology and Community Health. 2023 FRIDAID 2202404 doi:10.1136/jech-2023-220928 0143-005X 1470-2738 https://hdl.handle.net/10037/32263 |
op_rights |
Attribution 4.0 International (CC BY 4.0) openAccess Copyright 2023 The Author(s) https://creativecommons.org/licenses/by/4.0 |
op_doi |
https://doi.org/10.1136/jech-2023-220928 |
container_title |
Journal of Epidemiology and Community Health |
container_volume |
78 |
container_issue |
2 |
container_start_page |
88 |
op_container_end_page |
97 |
_version_ |
1789339593617702912 |