The contribution that financial hardship and wealth shock makes to negative health outcomes on psychosocial health and all-cause mortality has been widely documented in a global context.

Its effects are often amplified among the elderly, who are frequently burdened with a higher financial and medical vulnerabilities. In a novel exploration of the health outcomes of financial distress, Cho and colleagues explored the effects of extreme wealth loss on cognitive health in late adulthood across the US, England, China, and Mexico. Their work, published in a recent edition of The Lancet Healthy Longevity, proposes that extreme losses in wealth, or “wealth shocks,” can detrimentally affect cognitive performance, and notes that this relationship may vary by geography and access to state material support for the elderly.

This has particularly relevant implications for the prevalence of dementia in these countries, which GlobalData epidemiologists estimate will increase from 8,780,000 cases in 2023 to over 12,600,000 cases by 2032, given that is frequently preceded by a decline in cognitive function.

To analyse the relationship between negative wealth shocks and cognitive function, Cho and colleagues utilized population-based health and retirement studies based in the US, China, England, and Mexico between 2012 and 2018. The databases consisted of 9,465 participants, whose histories were analysed for the incidence of negative wealth shock, defined as either a loss of 75% or more from baseline wealth or a decline of wealth quintile rank.

Cognitive function was measured using a score derived from participant performance in the Harmonized Cognitive Assessment Protocol (HCAP) administered in all four countries. An analysis showed that participants in England and the US reported lower exposure to wealth shock compared to those in China and Mexico. Furthermore, those experiencing wealth shock in the US and China saw significant declines in cognitive function, while those in England and Mexico did not.

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In order to analyse associations between particular components of wealth loss and cognitive decline, the authors controlled for loss in housing value and asset value, respectively.

Results suggest that while no significant effect was observed among those losing asset value, declines in housing value were correlated with cognitive decline. Cho and colleagues propose that England’s long-established social welfare system, as well as a comprehensive pension program for seniors in Mexico, may account not only for a reduction in wealth shock, but also serve as a buffer for the degenerative cognitive effects of exposure to financial hardship among the elderly.

The analysis carried out by Cho and colleagues emphasises the health outcomes of material conditions among the elderly. The fact that one middle-income and one high-income nation showed significant declines, as opposed to two high-income nations, suggests that generous social welfare programs, as opposed to absolute wealth, may play a stronger mediating role in the financial security of older adults.

Considering the downstream health outcomes that socioeconomic status has on seniors’ cognitive health, these conclusions may play a crucial role in informing state policies and retirement benefits systems. As dementia and other age-related illnesses exert a growing disease burden on nations with growing elderly populations, policies considering the intersection of age, material status, and health will be of paramount importance.