ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025
Neighborhood deprivation and midlife cognition: Evidence of a modifiable vascular pathway involving health behaviors and cerebral small vessel disease.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The experiences of living with dementia within an under-served geographical area: a systematic review and qualitative synthesis.Age and ageing · 2026Pooled it
- Multimorbidity, Polypharmacy, and Neighborhood Disadvantage as Determinants of Cognitive Performance in the ARCHES Cohort.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Older adults in more disadvantaged neighborhoods exhibit brain vascular dysfunction.Cerebral circulation - cognition and behavior · 2026Article
- Neighborhood deprivation and midlife cognition: Evidence of a modifiable vascular pathway involving health behaviors and cerebral small vessel disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
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Authors and funding
23 authors.
Funding
Abstract
introductionNeighborhood deprivation increases dementia risk, although mechanisms remain unclear. We tested a framework in which modifiable risk factors and cerebral small vessel disease (SVD) mediate the link between neighborhood deprivation and cognition.
methodsIn 585 cognitively healthy midlife adults (ages 40-59), neighborhood deprivation was derived from postcodes, cognition was assessed using the COGNITO, lifestyle risk factors were measured using clinical assessments, and SVD (white matter hyperintensities, lacunes, microbleeds, perivascular spaces) was assessed on 3T magnetic resonance imaging. Multivariate analyses examined association pathways among these variables.
resultsNeighborhood deprivation was associated with poorer cognition (r = 0.36, p < 0.001), greater prevalence of modifiable risk factors (r = 0.36, p < 0.001), and greater SVD burden (β = 0.18, p = 0.008). Serial mediation showed that the effects of deprivation on cognition were indirect, possibly operating via lifestyle risk and SVD, explaining 20% of the total effect, whereas SVD alone explained 28%. DISCUSSION: Neighborhood disadvantage relates to poorer cognition, possibly mediated through vascular risk factors and cerebrovascular disease. HIGHLIGHTS: Neighborhood deprivation linked to poorer cognition in healthy midlife adults Deprivation linked to small vessel disease (SVD) and modifiable risk factors (chiefly cardiovascular risk) Association between deprivation and cognition mediated by modifiable risk and SVD Mediation was exclusive to hypertensive SVD, but not cerebral amyloid angiopathy (CAA)-related SVD.
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