Association of neighborhood socioeconomic disadvantage and cognitive impairment

Maria Vassilaki, Jeremiah A. Aakre, Anna Castillo, Alanna M. Chamberlain, Patrick M. Wilson, Walter K. Kremers, Michelle M. Mielke, Yonas E. Geda, Mary M. Machulda, Rabe E. Alhurani, Jonathan Graff-Radford, Prashanthi Vemuri, Val J. Lowe, Clifford R. Jack, David S. Knopman, Ronald C. Petersen

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)761-770
Number of pages10
JournalAlzheimer's and Dementia
Issue number3
StatePublished - Mar 2023
Externally publishedYes


  • area deprivation index
  • dementia
  • mild cognitive impairment
  • neighborhood socioeconomic disadvantage

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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