The Impact of Social Vulnerability in the Elderly Cognition

Abstract

In order to accurately detect cognitive deficits these factors are usually controlled in neuropsychological testing through the useof pertinent normative data. Besides educational level, social vulnerability implies other variables that have also been shown tohave an impact on cognitive decline during ageing such as socioeconomic status. However, the impact of these variables is not oftenconsidered while conducting neuropsychological assessments, neither in clinical nor experimental settings.Objective: to compare cognitive performance of a group of healthy older adults considered part of a socially vulnerable context witha group of similar sex, age and educational level but considered part of a non-vulnerable context.Materials and Methods: 60 participants were included in the study: 30 were part of a socially vulnerable context (Group-1) and theother 30 were outside of that context (Group-2). They underwent a neuropsychological assessment which included cognitive (ACEIII) and executive (IFS) and social cognition (Mini-SEA) screening tests, together with several other neuropsychological instrumentsclassically used to assess different cognitive dominions.Results: Significant differences were observed in cognitive performance between both groups (G1 y G2). Even when the cut-off pointfor low educational level was used, in G1 values below the cut-off point were found in more than 80% of the cases.Conclusion: This study shows the impact that being part of a socially vulnerable context has on cognitive performance with themajority of healthy subjects of the socially vulnerable group being misclassified as demented even with the low educational cutofftaken into account. This finding is of great importance for clinical and experimental neuropsychological assessment worldwide, butmainly in regions such as LA where social vulnerability must be taken into consideration when selecting normative data to infer thepresence of cognitive deficits.