Summary: Living in disadvantaged neighborhoods is associated with higher blood pressure and lower cognitive performance, even in individuals without mild cognitive impairment. Researchers analyzed over 500 adults, finding that poor social and economic resources in neighborhoods exacerbate cardiometabolic health issues and reduce brain function.
For those already diagnosed with mild cognitive impairment, the effects extended to higher blood sugar levels. The study highlights the urgent need to address social determinants of health to reduce risks for dementia and related conditions.
Key Facts:
- Neighborhood Impact: Disadvantaged environments correlate with higher blood pressure and reduced cognitive scores, even without cognitive impairment.
- Cognition and Cardiometabolism: Cardiometabolic health issues like high blood sugar further worsen in individuals with mild cognitive impairment in disadvantaged neighborhoods.
- Structural Solutions: Addressing social determinants of health can mitigate risks for both cardiometabolic and cognitive decline.
Source: Wake Forest University
New research from Wake Forest University School of Medicine suggests that living in a disadvantaged neighborhood is associated with higher blood pressure and lower cognitive scores, even among people who do not have an existing diagnosis of mild cognitive impairment.
The study appears online today in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, a journal of the Alzheimer’s Association.
“We know that inequitable access to education, employment, income and housing increases the risk for Alzheimer’s disease and related dementias,” said James R. Bateman, M.D., assistant professor of neurology at Wake Forest University School of Medicine and principal investigator of the study.
“However, more research is needed to better understand the impact of social determinants of health, including what this study analyzed with neighborhood disadvantage.”
Bateman said neighborhood disadvantage refers to the lack of social and economic resources in one’s environment. To assess neighborhood disadvantage, the research team used the highly recognized national Area Deprivation Index, which measures housing quality, education and income.
“Our goal of the study was to analyze the relationship of neighborhood disadvantage with measures of cardiometabolic health and cognition in individuals with and without diagnosed mild cognitive impairment,” said Bateman, who is also a neurologist at Atrium Health Wake Forest Baptist.
Bateman said it was important for the team to compare individuals with a diagnosis to those without one to better understand how a person’s current cognitive state impacts the relationship between their environment and their health.
Cognition refers to the mental process of thinking, learning, remembering, being aware of surroundings and using judgment. Mild cognitive impairment is a decline in memory and thinking skills that is greater than expected with normal aging and is a risk factor for dementia.
Bateman noted that many cardiometabolic diseases may increase the risk for cognitive impairment and dementia. Cardiometabolic health is the cardiovascular and metabolic health of an individual and involves the management of risk factors such as blood glucose, high blood pressure, high cholesterol and obesity.
For the study, Bateman and team analyzed data from 537 adults over the age of 55 from the Alzheimer’s Disease Research Center Healthy Brain Study at Wake Forest University School of Medicine from 2016 to 2021.
Individuals received clinical exams, neurocognitive testing and neuroimaging, in addition to cardiometabolic tests to screen for diabetes, high cholesterol and high blood pressure.
The neurocognitive testing included in the study evaluated constructs such as memory, executive function, language, visuospatial skills, concentration and attention.
“We found an association between neighborhood disadvantage and higher blood pressure and cardiometabolic index, as well as lower cognitive scores in individuals who did not have a diagnosed mild cognitive impairment,” said Sudarshan Krishnamurthy, a fifth-year M.D./Ph.D. student at Wake Forest University School of Medicine and first author of the paper.
Krishnamurthy said that neighborhood disadvantage was only associated with higher hemoglobin A1C, which measures blood sugar, in people with diagnosed mild cognitive impairment.
“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,” Bateman said. “Our study highlights the importance of implementing structural changes to address social determinants of health to mitigate cardiometabolic and cognitive risks.”
Krishnamurthy added that the study underscores the impact of a person’s living environment.
“This study confirms what we had hypothesized: 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,” Krishnamurthy said.
Funding: This study was supported by funding from NIH P30 AG072947, AHA 24PRE1200264, R01AG054069, R01AG058969, NIH R01 AG072547, NIH R01 AG079388, NIH UG1 CA189974 and NIH U19 AG074865.
About this neuroscience and cognition research news
Author: Myra Wright
Source: Wake Forest University
Contact: Myra Wright – Wake Forest University
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Impact of neighborhood disadvantage on cardiometabolic health and cognition in a community-dwelling cohort” by James R. Bateman et al. Alzheimer’s & Dementia: Diagnosis Assessment & Disease Monitoring
Abstract:
Impact of neighborhood disadvantage on cardiometabolic health and cognition in a community-dwelling cohort
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.
