Home › Research › Risk factors
Association of neighborhood socioeconomic disadvantage and cognitive decline
Karyn Marsh, Yongzhao Shao, Yian Zhang, Arjun V. Masurkar, Alok Vedvyas, Joshua Chodosh. Alzheimer s & Dementia, 2021-12-01
Topic: Risk, prevention and care in population studies
Abstract Background There is increasing emphasis on research recruitment of persons of color to understand the influence of race/ethnicity on Alzheimer’s disease (AD) and AD‐related dementia (ADRD) risk. Normal persons with subjective cognitive decline (SCD) are considered at risk for future decline as SCD is thought to be a preclinical stage of AD/ADRD. Yet the validity of SCD across racial and ethnic groups is unclear. Race/ethnicity‐related conditions such as socio‐economic disadvantage, neighborhood segregation, and poor housing quality (neighborhood deprivation) are important factors in stress, discrimination and other social determinants of health and may provide more in‐depth explanations for SCD than race/ethnicity alone. Method We examined the role of neighborhood deprivation and compared this to the role of race/ethnicity in SCD using a validated instrument, the Brief Cognitive Rating Scale (BCRS). Using the Area Deprivation Index (ADI), we cross‐sectionally examined the relationship between neighborhood characteristics and SCD in a racially and ethnically diverse group of community‐residing older adults in New York City. For those having available addresses, we used data from participants with normal cognition in the NYU Alzheimer’s Disease Research Center (n=313) and conducted multivariable logistic regressions, comparing two models with the BCRS as our outcome: using the ADI without race/ethnicity and then with race/ethnicity, both adjusting for age, sex, education (years). Result Participant mean age was 72.8.0 ± 7.4 years; mean education was 16.3± 3.1 years. Seventy‐six percent of the cohort was female (n=232); 12.1% (n= 38) reported as Hispanic, 73.5% (n=230) non‐Hispanic (NH) White; 13.4% reported as NH Black or African‐American (n=42); and 3 were other. In multivariable logistic regressions of BCRS domain‐specific analysis, ADI was a significant predictor of BCRS‐measured SCD even when race/ethnicity was included as a covariate (p<0.05), suggesting independent influence of neighborhood deprivation. Conclusion Neighborhood characteristics may play an influential role in SCD regardless of race/ethnicity and thus are likely important risk factors for AD/ADRD. If larger and more diverse studies generate similar findings, neighborhood investment and recruitment goals for AD/ADRD studies will require more focus on neighborhoods with greater deprivation.
Key findings
- Result Participant mean age was 72.8.0 ± 7.4 years; mean education was 16.3± 3.1 years.
- In multivariable logistic regressions of BCRS domain‐specific analysis, ADI was a significant predictor of BCRS‐measured SCD even when race/ethnicity was included as a covariate (p<0.05), suggesting independent influence of neighborhood deprivation.
Why it matters
In 313 older adults with normal cognition in New York City, neighborhood deprivation predicted subjective cognitive decline even when race and ethnicity were accounted for. This suggests neighborhood conditions may matter independently, but the study was cross-sectional and cannot show cause and effect.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Participants313
- Effect size12.1%; 73.5%; 13.4%
- Evidence strengthModerate
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 313 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.4 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 1 / 6 | Cited 0.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Joshua Chodosh: h-index 39 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | New York University: institution h-index 1,612 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 40 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Marsh, K., Shao, Y., Zhang, Y., Masurkar, A. V., Vedvyas, A., & Chodosh, J. (2021). Association of neighborhood socioeconomic disadvantage and cognitive decline. Alzheimer s & Dementia. https://doi.org/10.1002/alz.056584
Vancouver
Marsh K, Shao Y, Zhang Y, Masurkar AV, Vedvyas A, Chodosh J. Association of neighborhood socioeconomic disadvantage and cognitive decline. Alzheimer s & Dementia. 2021. doi:10.1002/alz.056584.
BibTeX
@article{marsh2021-25b8240b,
author = {Marsh, Karyn and Shao, Yongzhao and Zhang, Yian and Masurkar, Arjun V. and Vedvyas, Alok and Chodosh, Joshua},
title = {{Association of neighborhood socioeconomic disadvantage and cognitive decline}},
journal = {Alzheimer s \& Dementia},
year = {2021},
doi = {10.1002/alz.056584},
url = {https://doi.org/10.1002/alz.056584}
}
Related studies in Risk factors
Also tagged “cognitive-function”
1,118 studies in the library carry the topic tag “cognitive-function”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,118 tagged studies.