Dementia risk may be elevated in socioeconomically disadvantaged neighborhoods. Reasons for this remain unclear, and this elevation has yet to be shown at a national population level.
We tested whether dementia was more prevalent in disadvantaged neighborhoods across the New Zealand population (N = 1.41 million analytic sample) over a 20-year observation. We then tested whether premorbid dementia risk factors and MRI-measured brain-structure antecedents were more prevalent among midlife residents of disadvantaged neighborhoods in a population-representative NZ-birth-cohort (N = 938 analytic sample).
People residing in disadvantaged neighborhoods were at greater risk of dementia (HR per-quintile-disadvantage-increase = 1.09, 95% confidence interval [CI]:1.08-1.10) and, decades before clinical endpoints typically emerge, evidenced elevated dementia-risk scores (CAIDE, LIBRA, Lancet, ANU-ADRI, DunedinARB; β’s 0.31-0.39) and displayed dementia-associated brain structural deficits and cognitive difficulties/decline.
Disadvantaged neighborhoods have more residents with dementia, and decades before dementia is diagnosed, residents have more dementia-risk factors and brain-structure antecedents. Whether or not neighborhoods causally influence risk, they may offer scalable opportunities for primary dementia prevention.

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This post is Copyright: Aaron Reuben,
Leah S. Richmond‐Rakerd,
Barry Milne,
Devesh Shah,
Amber Pearson,
Sean Hogan,
David Ireland,
Ross Keenan,
Annchen R. Knodt,
Tracy Melzer,
Richie Poulton,
Sandhya Ramrakha,
Ethan T. Whitman,
Ahmad R. Hariri,
Terrie E. Moffitt,
Avshalom Caspi | March 14, 2024

Wiley: Alzheimer’s & Dementia: Table of Contents