Social class, dementia and the fourth age

Abstract

Research addressing social class and dementia has largely focused on measures of socioeconomic status as causal risk factors for dementia and in observed differences in diagnosis, treatment and care. This large body of work has produced important insights but also contains numerous problems and weaknesses. Research needs to take account of the ways in which ageing and social class have been transformed in tandem with the economic, social and cultural coordinates of late modernity. These changes have particular consequences for individual identities and social relations. With this in mind this article adopts a critical gaze on research that considers interactions between dementia and social class in three key areas: (i) epidemiological approaches to inequalities in risk (ii) the role of social class in diagnosis and treatment and (iii) class in the framing of care and access to care. Following this, the article considers studies of dementia and social class that focus on lay understandings and biographical accounts. Sociological insights in this field come from the view that dementia and social class are embedded in social relations. Thus, forms of distinction based on class relations may still play an important role in the lived experience of dementia.

Dementia as a source of social disadvantage and exclusion

“…While other studies emphasise the determining influence of socio‐economic status, this study is too small to draw conclusions of this type. It can, however, form the basis for more extensive future research.…”

“…The consistent message of public health and epidemiological research is that social disadvantage and dementia are interconnected: with those suffering social disadvantage being more at risk of developing dementia in later life. These studies present the relationship between social disadvantage, exclusion and dementia in a certain way, however: situating social location as the preeminent factor in how dementia is understood and experienced . They do not therefore address the possibility that social identity may be directly impacted by dementia or that unique forms of disadvantage and exclusion arise because of the condition.…”

“…At the same time, factors associated with higher socio‐economic status, such as occupational status and education attainment, correlate with lower levels of prevalence . Jones suggests that effects are cumulative, with strong correlations between social class and access to dementia diagnosis, treatment and care . The consistent message of public health and epidemiological research is that social disadvantage and dementia are interconnected: with those suffering social disadvantage being more at risk of developing dementia in later life.…”

Analyzing the chance of developing dementia among geriatric people: a cross‐sectional pilot study in Bangladesh

“…The relationship between dementia and social status is prominent . Studies suggested that socioeconomic position and being working class are major risk factors for developing dementia . Other probable factors for dementia are inconsistency in diagnosis, access to treatment and care, and personal perceptions of disease .…”

Cultural representations of dementia

“…Differences in the ways in which dementia is conceptualised may also be shaped by social location. Although work on social class and dementia tends to be restricted to differences in associated risk factors for developing the condition or different levels of access to diagnosis, care, and support, there is a growing recognition that social class identities have a significant role to play in the ways in which dementia is both experienced and conceptualised [10]. …”