Home › Research › Risk factors
Social determinants of brain structure and cognition
Mayeli Mahsa, Matuskey David. Social science & medicine (1982), 2026-02-09
Topic: Risk, prevention and care in population studies
Socioeconomic disadvantage is recognized as a risk factor for cognitive decline, yet its associated neural pathways remain unclear. We investigated whether neighborhood disadvantage, measured by the Area Deprivation Index (ADI), was associated with cognitive performance in older adults and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), and whether structural brain differences explained this relationship. Participants included 822 older adults (478 cognitively unimpaired [CU], 271 with MCI, and 73 with AD). Associations between ADI, cognition, and brain structure were examined using regression models adjusting for age and sex. Mediation analyses tested whether total brain volume accounted for ADI-cognition relationships. Higher ADI was associated with poorer cognitive performance across all domains in CU individuals (National ADI: memory β = -0.008, p < 0.001; executive function β = -0.005, p < 0.001; language β = -0.005, p < 0.001; visuospatial β = -0.004, p < 0.001) and across multiple domains in MCI (memory β = -0.007, p = 0.002; executive β = -0.007, p < 0.001). ADI was also associated with smaller total cerebral, gray, and white matter volumes in CU (State ADI and gray matter β = -2.37, FDR-p = 0.006) and greater white matter hyperintensity burden (β = 0.152, FDR-p = 0.009). Associations were weaker in MCI and absent in AD. Mediation analyses showed that total brain volume significantly mediated the effect of ADI on language performance (ACME p = 0.024; proportion mediated = 19.7 %, p = 0.036). Neighborhood disadvantage is linked to widespread cognitive vulnerability and structural brain differences. However, brain volume explains only a small portion of these associations, suggesting that environmental and contextual factors shape cognitive performance through pathways that extend beyond structural neurodegeneration.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mahsa, M., & David, M. (2026). Social determinants of brain structure and cognition. Social science & medicine (1982). https://doi.org/10.1016/j.socscimed.2026.119045
Vancouver
Mahsa M, David M. Social determinants of brain structure and cognition. Social science & medicine (1982). 2026. doi:10.1016/j.socscimed.2026.119045. PMID: 41662789.
BibTeX
@article{mahsa2026-41662789,
author = {Mahsa, Mayeli and David, Matuskey},
title = {{Social determinants of brain structure and cognition}},
journal = {Social science \& medicine (1982)},
year = {2026},
doi = {10.1016/j.socscimed.2026.119045},
pmid = {41662789},
url = {https://doi.org/10.1016/j.socscimed.2026.119045}
}
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
- We investigated whether neighborhood disadvantage, measured by the Area Deprivation Index (ADI), was associated with cognitive performance in older adults and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), and whether structural brain differences explained this relationship.
- Higher ADI was associated with poorer cognitive performance across all domains in CU individuals (National ADI: memory β = -0.008, p < 0.001; executive function β = -0.005, p < 0.001; language β = -0.005, p < 0.001; visuospatial β = -0.004, p < 0.001) and across multiple domains in MCI (memory β = -0.007, p = 0.002; executive β = -0.007, p < 0.001).
- ADI was also associated with smaller total cerebral, gray, and white matter volumes in CU (State ADI and gray matter β = -2.37, FDR-p = 0.006) and greater white matter hyperintensity burden (β = 0.152, FDR-p = 0.009).
- Mediation analyses showed that total brain volume significantly mediated the effect of ADI on language performance (ACME p = 0.024; proportion mediated = 19.7 %, p = 0.036).
- However, brain volume explains only a small portion of these associations, suggesting that environmental and contextual factors shape cognitive performance through pathways that extend beyond structural neurodegeneration.
Why it matters
Higher neighborhood disadvantage was associated with poorer cognitive performance and smaller brain volumes in cognitively unimpaired older adults, with weaker associations in mild cognitive impairment and none in Alzheimer's disease. It describes associations with brain structure and cognition, not any treatment, cure, or prevention.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Participants822
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Social science & medicine (1982)) |
| Journal's citation record | 3 / 4 | Social Science & Medicine: journal h-index 391 (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 | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 822 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 1 times (OpenAlex, 2026-10-17) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 4.5× 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 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author David Matuskey: h-index 41 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Yale University: institution h-index 1,922 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41662789) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.
Related studies in Risk factors
Also in Risk factors
356 studies in the library are filed under Risk factors with no topic tag they share with another; these are this study's neighbours in a fixed tour of them. The Risk factors hub.