Our results supported our hypothesis. We found that patients with AD at presentation to our memory clinic had lower SES than patients with MCI (Figure 2), and that lower SES patients present to clinic at an older age; about 4 years older. In addition, within patients with MCI, lower SES was associated with greater disease severity as measured by extensive cognitive tests. Next, we investigated the use of cognitive enhancers between high and low SES patients with AD and found that lower SES was associated with reduced use of cognitive enhancers.

Our study looked at how SES can influence the initial presentation to the Memory Disorders Clinic at St. Michael’s Hospital located in the urban setting of Toronto, Canada (Figure 1). We hypothesized that lower SES would negatively impact medical outcome by delaying the detection and diagnosis of AD. Patients seen at the clinic, which subserves a population with a wide range of SES, are referred from their family physicians. SES was measured using Hollingshead two-factor index, which combines educational and occupational attainments. The index ranges from 11-77 and is negatively correlated with observed SES. Healthcare is fully funded by the provincial government through the Ontario Health Insurance Program (OHIP).