Association of neighborhood socioeconomic disadvantage and cognitive impairment - PubMed (original) (raw)

. 2023 Mar;19(3):761-770.

doi: 10.1002/alz.12702. Epub 2022 Jun 6.

Jeremiah A Aakre 1, Anna Castillo 1, Alanna M Chamberlain 1 2, Patrick M Wilson 1, Walter K Kremers 1, Michelle M Mielke 1 3, Yonas E Geda 4, Mary M Machulda 5, Rabe E Alhurani 6 7, Jonathan Graff-Radford 6, Prashanthi Vemuri 8, Val J Lowe 8, Clifford R Jack Jr 8, David S Knopman 6, Ronald C Petersen 1 6

Affiliations

Association of neighborhood socioeconomic disadvantage and cognitive impairment

Maria Vassilaki et al. Alzheimers Dement. 2023 Mar.

Abstract

Introduction: We investigated the association of the area deprivation index (ADI) with cognitive decline, mild cognitive impairment (MCI), and dementia in older adults (≥50 years old). ADI is a neighborhood socioeconomic disadvantage measure assessed at the census block group level.

Methods: The study included 4699 participants, initially without dementia, with available ADI values for 2015 and at least one study visit in 2008 through 2018. Using logistic regression and Cox proportional hazards models with age as the time scale, we assessed the odds for MCI and the risk for dementia, respectively.

Results: In cognitively unimpaired (CU) adults at baseline, the risk for progression to dementia increased for every decile increase in the ADI state ranking (hazard ratio = 1.06, 95% confidence interval (1.01-1.11), P = .01). Higher ADI values were associated with subtly faster cognitive decline.

Discussion: In older CU adults, higher baseline neighborhood socioeconomic deprivation levels were associated with progression to dementia and slightly faster cognitive decline.

Highlights: The study used area deprivation index, a composite freely available neighborhood deprivation measure. Higher levels of neighborhood deprivation were associated with greater mild cognitive impairment odds. Higher neighborhood deprivation levels were associated with higher dementia risk.

Keywords: area deprivation index; dementia; mild cognitive impairment; neighborhood socioeconomic disadvantage.

© 2022 the Alzheimer's Association.

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Figures

Figure 1.

Figure 1.

Risk of dementia for cognitively unimpaired participants in the 5th quintile (most deprived) compared to all others by (A) State neighborhood disadvantage (as assessed by the State ADI ranking), and (B) National neighborhood disadvantage (as assessed by the National ADI ranking), conditional on being cognitive unimpaired at age 65 years. Unadjusted analyses using age as the timescale.

References

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