The Effect of a Targeted Cash Transfer on Cognitive Function in Later Life: Evidence from a Gene-by-Environment Interaction

Emilie Courtin, Harvard University
Sally Hayward, London School of Hygiene and Tropical Medicine
Jennifer B. Dowd , Leverhulme Centre for Demographic Science, University of Oxford

We examined whether the Winter Fuel Payment - an unconditional targeted cash transfer - improves cognitive function among older people in England; and whether this effect varied by genetic makeup. Data came from the English Longitudinal Study of Ageing (ELSA, 2002-10, N=13,663). To overcome the limitations of previous gene-by environment studies, we assessed the effect of receiving the cash transfer on cognition using individual fixed effects to minimize confounding. Receipt of the transfer was interacted with polygenic risk scores for Alzheimer’s disease and general cognition to examine whether the effect varied by genetic predisposition. Receiving the cash transfer was associated with an 0.024 increase (95% confidence interval [CI]: 0.001 to 0.046) in the total cognitive function z-score, driven primarily by improvements in executive function. Respondents in the highest quartile of polygenic risk for Alzheimer’s experienced larger increases in total cognition (?=0.076, 95% CI: 0.01 to 0.142) compared to those in the lowest quartile. Genetic predisposition for general cognition did not modify the effect of the cash transfer on cognition. These results support the potential for social policies to improve cognition in later life and highlight the ability of the social environment to mitigate genetic risk factors.

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 Presented in Session 5. Health, Wellbeing and Morbidity