@article {Kobayashijech-2021-217059,
	title = {Subjective social position and cognitive function in a longitudinal cohort of older, rural South African adults, 2014{\textendash}2019},
	journal = {Journal of Epidemiology \& Community Health},
	year = {2021},
	publisher = {BMJ Publishing Group Ltd},
	abstract = {Background The relationship between subjective social position (SSP) and cognitive ageing unclear, especially in low-income settings. We aimed to investigate the relationship between SSP and cognitive function over time among older adults in rural South Africa.Methods Data were from 3771 adults aged >=40 in the population-representative {\textquoteleft}Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa{\textquoteright} from 2014/2015 (baseline) to 2018/2019 (follow-up). SSP was assessed at baseline with the 10-rung MacArthur Network social position ladder. Outcomes were composite orientation and episodic memory scores at baseline and follow-up (range: 0{\textendash}24). Mortality- and attrition-weighted linear regression estimated the associations between baseline SSP with cognitive scores at each of the baseline and follow-up. Models were adjusted for age, age2, sex, country of birth, father{\textquoteright}s occupation, education, employment, household assets, literacy, marital status and health-related covariates.Results SSP responses ranged from 0 (bottom ladder rung/lowest social position) to 10 (top ladder rung/highest social position), with a mean of 6.6 (SD: 2.3). SSP was positively associated with baseline cognitive score (adjusted β=0.198 points per ladder rung increase; 95\% CI 0.145 to 0.253) and follow-up cognitive score (adjusted β=0.078 points per ladder rung increase; 95\% CI 0.021 to 0.136).Conclusion Independent of objective socioeconomic position measures, SSP is associated with orientation and episodic memory scores over two time points approximately 3 years apart among older rural South Africans. Future research is needed to establish the causality of the observed relationships, whether they persist over longer follow-up periods and their consistency in other populations.Data are available in a public, open access repository.},
	issn = {0143-005X},
	doi = {10.1136/jech-2021-217059},
	url = {https://jech.bmj.com/content/early/2021/09/23/jech-2021-217059},
	author = {Kobayashi, Lindsay C and Morris, Emily P and Harling, Guy and Farrell, Meagan T and Kabeto, Mohammed U and Wagner, Ryan G and Berkman, Lisa F}
}
