ArticleJournal of applied gerontology : the official journal of the Southern Gerontological Society2026
Multimorbidity, Polypharmacy, and Neighborhood Disadvantage as Determinants of Cognitive Performance in the ARCHES Cohort.
Article in Journal of applied gerontology : the official journal of the Southern Gerontological Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BackgroundAfrican American adults experience a disproportionate burden of dementia, shaped by structural and clinical factors that remain unclear.ObjectiveTo quantify associations between multimorbidity, polypharmacy, and cognition in the context of neighborhood disadvantage.MethodsThis study is a cross-sectional analysis of 348 African American adults aged 45-92 years (mean 64.3 years; 73.6% female) from the Aging Research Characterizing Health Exposome via Social drivers (ARCHES) cohort. Comorbidity burden was assessed using a modified Charlson Comorbidity Index (CCI), polypharmacy as ≥5 medications, and neighborhood disadvantage using the Area Deprivation Index (ADI). Linear regression estimated associations with a Preclinical Alzheimer's Cognitive Composite (PACC). The polypharmacy model included modified CCI as a covariate, and effect modification by ADI was assessed using an interaction term between polypharmacy and ADI.ResultsHigher modified CCI was associated with lower cognitive performance (B = -0.071; 95% CI: -0.130, -0.012). Polypharmacy was not independently associated with cognition after modified CCI adjustment (B = -0.081; β = -0.057; p = 0.257). No significant ADI interaction was found (p = 0.064).
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