The Impact of Social Vulnerability in the Elderly Cognition

Introduction: Demographic factors like age, sex and educational level are the main variables known to have an impact on cognition.In order to accurately detect cognitive deficits these factors are usually controlled in neuropsychological testing through the use of pertinent normative data.Besides educational level, social vulnerability implies other variables that have also been shown to have an impact on cognitive decline during ageing such as socioeconomic status.However, the impact of these variables is not often considered 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 with a 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 the other 30 were outside of that context (Group-2).They underwent a neuropsychological assessment which included cognitive (ACE III) and executive (IFS) and social cognition (Mini-SEA) screening tests, together with several other neuropsychological instruments classically 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 point for 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 the majority of healthy subjects of the socially vulnerable group being misclassified as demented even with the low educational cutoff taken into account.This finding is of great importance for clinical and experimental neuropsychological assessment worldwide, but mainly in regions such as LA where social vulnerability must be taken into consideration when selecting normative data to infer the presence of cognitive deficits.