Home › Research › Risk factors
In the context of a deprived neighborhood, does self‐identified race cause dementia?
Xiao Zhang, Chung‐Chou H. Chang, Mary Ganguli. Alzheimer s & Dementia, 2023-06-01
Topic: Risk, prevention and care in population studies
Abstract Background Although accumulating evidence has shown that individual socioeconomic status affects dementia incidence, it remains unknown whether a higher degree of neighborhood disadvantage which is independent of individual socioeconomic status contributes to the excess risk of dementia among African Americans (AA). Method In the Monongahela‐Youghiogheny Healthy Aging Team and 15104 Senior Project, two population‐based prospective cohort studies in an economically disadvantaged Rust Belt community, 2733 participants aged 65+ years were assessed for their health history, lifestyle, and cognitive functioning. Mild cognitive impairment (MCI) or dementia was defined as Clinical Dementia Rating score ≥0.5. Each participant was assigned an Area Deprivation Index (ADI) value according to the census block group where one resided, indicating the level of neighborhood disadvantage. In cross‐sectional data, racial differences in the odds of MCI or dementia were assessed using weighted logistic regressions. Inverse probability weighting was used to balance AA and European Americans (EA) with respect to 1) ADI, 2) other confounders (age, sex, APOE*4 genotype, cardiometabolic diseases, individual socioeconomic status, health‐related behaviors, use of regular health services, functional health literacy, and air pollution [PM2.5]), and 3) ADI and other confounders. Result The frequency of MCI and dementia were 648 (24%) and 25 (0.9%), respectively. AA had significantly higher proportion of MCI or dementia (35% vs. 24%, p = 0.001) and higher mean ADI (96 vs. 79, p<0.0001) than EA. Being AA was associated with higher odds of MCI or dementia compared to being EA (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.26 ‐ 2.33, unadjusted model). After balancing racial groups with respect to ADI only, the difference between AA and EA no longer reached the level of significance. When balancing all other confounders only, the OR was 1.66 (95% CI = 1.04 ‐ 2.67) and the confounders explained 5.2% of the observed disparity. After balancing both ADI and other confounders, the difference again became non‐significant (OR = 1.61, 95% CI = 0.93 ‐ 2.80) and resulted in 11.1% of the MCI or dementia disparity being explained. Conclusion A higher degree of neighborhood disadvantage may contribute to the excess risk of MCI or dementia found among AA.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Zhang, X., Chang, C. H., & Ganguli, M. (2023). In the context of a deprived neighborhood, does self‐identified race cause dementia? Alzheimer s & Dementia. https://doi.org/10.1002/alz.066311
Vancouver
Zhang X, Chang CH, Ganguli M. In the context of a deprived neighborhood, does self‐identified race cause dementia? Alzheimer s & Dementia. 2023. doi:10.1002/alz.066311.
BibTeX
@article{zhang2023-1018cd31,
author = {Zhang, Xiao and Chang, Chung‐Chou H. and Ganguli, Mary},
title = {{In the context of a deprived neighborhood, does self‐identified race cause dementia?}},
journal = {Alzheimer s \& Dementia},
year = {2023},
doi = {10.1002/alz.066311},
url = {https://doi.org/10.1002/alz.066311}
}
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.
Key findings
- Abstract Background Although accumulating evidence has shown that individual socioeconomic status affects dementia incidence, it remains unknown whether a higher degree of neighborhood disadvantage which is independent of individual socioeconomic status contributes to the excess risk of dementia among African Americans (AA).
- Result The frequency of MCI and dementia were 648 (24%) and 25 (0.9%), respectively.
- AA had significantly higher proportion of MCI or dementia (35% vs. 24%, p = 0.001) and higher mean ADI (96 vs. 79, p<0.0001) than EA.
- Being AA was associated with higher odds of MCI or dementia compared to being EA (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.26 ‐ 2.33, unadjusted model).
- After balancing both ADI and other confounders, the difference again became non‐significant (OR = 1.61, 95% CI = 0.93 ‐ 2.80) and resulted in 11.1% of the MCI or dementia disparity being explained.
Why it matters
In two cohort studies in a disadvantaged Rust Belt community, African Americans had a higher proportion of mild cognitive impairment or dementia than European Americans and higher neighborhood disadvantage. The study used weighting to examine whether neighborhood disadvantage independent of individual socioeconomic status contributes to this difference.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Study designcohort study
- Participants2,733
- Effect size0.9%; 5.2%; OR = 1.61
- Evidence strengthModerate
How this study scored 48/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomized / 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 | 7 / 12 | A cohort study following people over time |
| 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 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,733 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 0 / 6 | Cited 0.0× 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 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Mary Ganguli: h-index 86 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Pittsburgh: institution h-index 1,470 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Related
Studies in the library that share something with this one. The line above each title says what.
Related studies in Risk factors
Also tagged “incidence”
1,084 studies in the library carry the topic tag “incidence”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,084 tagged studies.