Persistent Financial Hardship and Brain Health in Later Life

Persistent money problems seldom occur as one isolated incident. More often, they continue for years, gradually taking a cumulative toll on people.

Researchers at University College London (UCL) examined whether this prolonged burden affects the ageing brain. Using records spanning seven decades, they found that it does.

People who experienced ongoing financial difficulties during early and mid-adulthood performed less well in cognitive tests at 53.

Those living with both sustained money problems and a low income also had worse brain health many years later.

Tracking people across 70 years

The participants came from the National Survey of Health and Development, a British birth cohort established in 1946. It is the longest-running continuously studied birth cohort of its type.

The Medical Research Council (MRC) runs the survey. Participants were all born during one week in March 1946, and most remain involved today.

“Most studies on cognitive aging look at financial hardship at only a single point in time,” said Dr. Jacques Wels, the study’s corresponding author.

“Our study using several decades of data allows us to see that it is the accumulation of hardship over many years that is linked to the worst cognitive health outcomes, rather than occasional episodes of adversity.”

Assessing financial hardship and brain health

Among 2,759 participants, the researchers followed two forms of financial hardship throughout adulthood. The first was low household income, assessed when participants were 26, 43 and 53.

The second was self-reported hardship, including difficulty paying bills or managing from one month to the next. Participants were considered persistently affected only when they met the threshold on at least two occasions.

Cognition was assessed through two straightforward tasks. In one, participants had to cross out specified letters as quickly as possible, providing an approximate measure of processing speed.

For the other, they memorised 15 words and recalled as many as possible. Both tests were carried out again at ages 53, 63 and 69.

Effects of persistent money problems by midlife

Persistent low income affected around one in six participants, while continuing hardship affected approximately one in eight.

At 53, both groups achieved lower scores in the speed and memory tests. Put simply, they responded more slowly and recalled fewer words.

At midlife, verbal memory showed the larger decline. Processing speed was also lower, but the difference was smaller.

Scores generally fell as the number of hardship episodes increased. Although the effect was modest, it appeared consistently.

The unexpected memory findings

A surprising pattern appeared over the following years. From 53 to 69, memory scores among the hardship group dropped more slowly than in the rest of the participants.

At first, that sounds like good news. The reality is less comforting.

The people who faced financial hardship had already lost ground by midlife. With a lower starting point, they simply had less left to lose.

This pattern was seen only with enduring hardship rather than an occasional difficult period. Most of the harm had already happened by midlife.

What the brain scans revealed

A smaller set of participants underwent brain scans in their late 60s and early 70s. These scans assessed brain shrinkage and the fluid-filled spaces within the brain.

As those spaces widen, they typically signal poorer brain health. People with persistent low income showed more of this widening.

The difference was around 0.16 fluid ounces, or 4.7 millilitres, of additional ventricular space. Although that may sound small, it was associated with the length of time someone had lived on a low income.

The initial scans revealed no other distinct differences. More marked contrasts emerged when the researchers examined particular groups.

Groups with the greatest brain changes

The burden was not distributed equally. Three groups appeared particularly susceptible to its effects on the brain.

Men were more affected than women, both in cognitive test results at 53 and in later brain shrinkage.

One possible explanation is that men of this generation were commonly the primary earners, meaning financial pressure may have affected them more intensely.

A difficult childhood added to the risk as well. People who grew up disadvantaged and then experienced ongoing hardship showed faster shrinkage in memory-related regions.

The third group was people carrying the APOE-ε4 gene variant, which increases the risk of Alzheimer’s disease. Carriers who also experienced persistent financial hardship had the most substantial brain shrinkage.

How financial hardship may affect the brain

How might financial worries influence the brain? The researchers identify several possible mechanisms.

Constant worry about money takes up mental space. That leaves fewer mental resources for the kinds of tasks measured by memory and attention tests.

Long-term stress also drives inflammation in the body. Inflammation is known to accelerate brain aging.

The study did not measure any of these mechanisms directly. However, they offer a basis for understanding how the association could arise.

Limits of the research

Several limitations should be considered. Nearly all participants were white, while the subgroup receiving scans was healthier than average.

This combination may mean the actual effect is underestimated. The difference between men and women may also be shaped by the period studied, when men were often the only earners.

The associations remained after the researchers accounted for factors including childhood cognitive ability, education and early disadvantage.

The findings therefore indicated that financial hardship itself, rather than only the conditions around it, was linked to the outcome.

Stopping hardship from becoming long-lasting

“Our findings suggest that supporting people facing financial hardship and reducing chronic poverty could also help prevent cognitive decline and dementia cases in the future,” said Professor Praveetha Patala, the study’s co-author.

This message is especially significant while a record number of households report financial pressure.

The results indicate that a prolonged struggle, rather than one challenging year alone, may leave the most lasting impact.