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Living in a disadvantaged neighborhood may negatively affect both physical and cognitive health, even in individuals without a diagnosis of mild cognitive impairment (MCI), according to new research from Wake Forest University School of Medicine. Published in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, the study sheds light on how social determinants of health, such as income, housing, and education, may contribute to cardiometabolic risks and cognitive decline.
The study analyzed data from 537 adults aged 55 and older enrolled in the Alzheimer’s Disease Research Center Healthy Brain Study at Wake Forest University School of Medicine between 2016 and 2021. Participants underwent clinical exams, cardiometabolic health tests, neuroimaging, and neurocognitive testing to evaluate memory, executive function, language, visuospatial skills, and attention.
Neighborhood disadvantage was assessed using the Area Deprivation Index (ADI), which measures factors such as housing quality, education, and income. The researchers found that living in a disadvantaged neighborhood was associated with higher blood pressure and poorer cardiometabolic health, as well as lower cognitive scores in individuals without a diagnosed MCI. Among those with MCI, however, neighborhood disadvantage was only linked to higher hemoglobin A1C levels, a marker of blood sugar regulation.
“These findings show that living in a disadvantaged neighborhood has a bigger impact on heart health and brain function in people without preexisting cognitive issues,” said James R. Bateman, M.D., assistant professor of neurology at Wake Forest University School of Medicine and principal investigator of the study. Cardiometabolic conditions, such as high blood pressure, obesity, and diabetes, are known risk factors for cognitive decline and dementia, highlighting the importance of early intervention.
First author Sudarshan Krishnamurthy, an M.D./Ph.D. student at Wake Forest University, emphasized the study’s broader implications. “Where you live and the resources and opportunities that are available to you as a result have a tangible impact on your risk for dementia,” he said.
The study underscores the profound influence of environmental factors on health and calls for structural changes to address social determinants of health. Such changes could help reduce disparities in cardiometabolic and cognitive health outcomes and potentially lower the risk of Alzheimer’s disease and related dementias.