Impact of neighborhood disadvantage on cardiometabolic health and cognition in a community-dwelling cohort

Sudarshan Krishnamurthy; Lingyi Lu; Christian J Johnson; Laura D Baker; Xiaoyan Leng; Sarah A Gaussoin; Timothy M Hughes; Da Ma; Allison Caban-Holt; Goldie S Byrd; Suzanne Craft; Samuel N Lockhart; James R Bateman

doi:10.1002/dad2.70021

Impact of neighborhood disadvantage on cardiometabolic health and cognition in a community-dwelling cohort

Alzheimers Dement (Amst). 2024 Dec 6;16(4):e70021. doi: 10.1002/dad2.70021. eCollection 2024 Oct-Dec.

Authors

Affiliations

¹ Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Medical Center Boulevard Wake Forest University School of Medicine Winston-Salem North Carolina USA.
² Department of Biostatistics and Data Science, Medical Center Boulevard Wake Forest University School of Medicine Winston-Salem North Carolina USA.
³ Department of Gerontology Virginia Commonwealth University Richmond Virginia USA.
⁴ Maya Angelou Center for Health Equity Wake Forest University School of Medicine Winston-Salem North Carolina USA.
⁵ Department of Neurology, Medical Center Boulevard Wake Forest University School of Medicine Winston-Salem North Carolina USA.
⁶ VISN 6 Mental Illness Research, Education, and Clinical Center (MIRECC) Salisbury VA Medical Center Salisbury North Carolina USA.

Abstract

Introduction: Neighborhood disadvantage may be an important determinant of cardiometabolic health and cognitive aging. However, less is known about relationships among individuals with mild cognitive impairment (MCI).

Methods: The objective of this study is to investigate the relationship between neighborhood disadvantage measured by national Area Deprivation Index (ADI) rank with measures of cardiometabolic health and cognition among Wake Forest (WF) Alzheimer's Disease Research Center (ADRC) participants, with and without MCI.

Results: ADI was positively associated with blood pressure and cardiometabolic index (CMI), and negatively associated with global and Preclinical Alzheimer's Cognitive Composite (PACC5) scores, in cognitively unimpaired (CU) individuals. ADI was only positively associated with hemoglobin A1c (HbA1c) in MCI.

Discussion: Neighborhood disadvantage is associated more strongly with measures of cardiometabolic health and cognition among CU individuals rather than MCI. These findings demonstrate a need for structural solutions to address social determinants of health in an attempt to reduce cardiometabolic and cognitive risks.

Keywords: Alzheimer's disease and related dementias; health equity; neighborhood disadvantage; place‐based determinants of health; social determinants of health.