Cognitive functioning and socioeconomic factors: Findings from the German National Cohort (NAKO) 

To remain mentally fit for as long as possible in old age, it is important to understand which risk factors could impact cognitive functioning already early in life. Scientists led by the German Centre for Neurodegenerative Diseases (DZNE) in Greifswald and the Institute of Social Medicine, Occupational Medicine and Public Health (ISAP) at Leipzig University have used data from the German National Cohort (NAKO) to investigate the relationship between aspects of socioeconomic inequality and cognitive functioning. They observed that there is an association between cognitive functioning, particularly with increasing age, and living conditions. Future analyses should investigate the processes behind this in more detail in order to find ways of improving cognitive health in these population groups.  

Participants in the German National Cohort (NAKO), Germany’s largest population study, have been invited to the study centres for medical examinations. The examinations also include neuropsychological tests. These are established procedures for recording changes in cognitive functioning over the individual’s lifetime. The attention, concentration and memory tests involve, for example, naming as many words of a category as possible in a certain time or memorising words.   

The results of the neuropsychological tests of 158,144 participants in the NAKO baseline study as well as self-reported information on socio-economic factors and illnesses formed the basis of the current evaluation. “It is known that cognitive functioning declines with age; this begins already in mid-life. To better understand which factors, play a role in this, we analysed whether there is a relationship between cognitive functioning and the socioeconomic situation,” reports Dr Francisca Rodriguez, head of the “Psychosocial Epidemiology and Public Health” working group at the German Centre for Neurodegenerative Diseases (DZNE). Specifically, the possible influence of unemployment, living alone, and income was analysed. In terms of income, a distinction was made between people living above and below the poverty line as defined by the German government. 

The analysis showed predominantly that the cognitive functioning was lower among people below compared above the poverty line. These differences in cognitive functioning increased with age. However, the possibility of reverse causality cannot be ruled out when interpreting the results. This means, for example, that people with a faster cognitive decline may have difficulties earning a higher income. “For people who live alone, we observed only a small association with cognitive functioning. We therefore assume that a person’s social network could be more important than living alone,” explains Dr Francisca Rodriguez. “Our results show that having adequate financial resources may be important for maintaining cognitive functioning in old age. We need cognitive abilities to communicate, understand texts, and make decisions. All of this is important to be and remain an active part of our society in later life. It is therefore essential to explore ways to enhance cognitive abilities early in life and to maintain them in later life, particularly for those having to live with little money.” 

More information

Originalpublication 

Rodriguez, F. S., Röhr, S., Dragano, N. et al. Low income, being without employment, and living alone: how they are associated with cognitive functioning—Results from the German national cohort (NAKO). 2024 Aging, Neuropsychology, and Cognition, 1–16. https://doi.org/10.1080/13825585.2024.2438825 

Contact 

PD Dr. Francisca S. Rodriguez  
Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)  
Ellernholzstr. 1-2 
17489  Greifswald 
francisca-saveria.rodriguez@dzne.de 

Weitere Informationen im Internet 

Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)

Press contact:

Dr. Friederike Fellenberg
NAKO Gesundheitsstudie
Head of Project and Science Communication
Am Taubenfeld 21/2
69123 Heidelberg
Germany
Phone.: +49 6221 42620-62
E-mail: friederike.fellenberg@nako.de

German National Cohort (NAKO)

The German National Cohort (NAKO Gesundheitsstudie) is the largest long-term population study in Germany. Since 2014, over 205,000 randomly selected people have been medically examined and asked about their lifestyle habits in 18 study centres. At the beginning of the study, the participants were aged between 20 and 69.

The German National Cohort (NAKO) is a prospective epidemiological cohort study. The researchers observe a large group, a so-called cohort, of healthy, ill or formerly ill people over a long period of time. The aim is to use scientific analyses of the participants’ data to investigate the frequency and causes of common diseases such as cancer, diabetes or cardiovascular diseases, to identify risk factors and to show ways of effective prevention and early detection.

The research project is supported by 26 organisations. Scientists from universities, the Helmholtz Association, the Leibniz Association and other research institutes in Germany are working together in a nationwide network. The study is being carried out by the NAKO e.V. association. It is financed by public funds from the Federal Ministry of Education and Research (BMBF), the Helmholtz Association and the participating federal states.