A recent study published on March 26, 2025, in Neurology®, the medical journal of the American Academy of Neurology, reveals a striking link between living in disadvantaged neighborhoods and an increased risk of developing dementia. The study, led by Pankaja Desai, PhD, from Rush University in Chicago, Illinois, highlights how community-level factors such as income, employment, education, and disability may influence the risk of dementia in older adults. While the study shows an association between neighborhood disadvantage and dementia risk, it does not prove causation.
Neighborhoods were assessed based on socioeconomic factors, including income levels, employment status, education attainment, and the prevalence of disability within the community. The study’s findings suggest that the community environment where individuals reside may play a significant role in their cognitive health, with disadvantaged neighborhoods associated with a higher likelihood of dementia development.
Dr. Desai emphasized the importance of considering neighborhood factors when evaluating dementia risk. “Most studies of risk factors for Alzheimer’s disease focus on the individual level, not the community level,” she noted. While it is challenging to intervene at the community level, she argued that prioritizing support for disadvantaged communities could be a practical approach to mobilizing resources and reducing dementia risk for the broader population.
The study followed 6,781 participants with an average age of 72, living in four different neighborhoods in Chicago. The participants underwent memory and thinking tests at the beginning of the study, with subsequent evaluations every three years over a follow-up period of at least six years. Among these participants, 2,534 were evaluated for dementia, with the study group consisting of 66% Black participants and the remaining 34% White participants.
Researchers used U.S. Census tracts, which represent small areas within counties, to categorize the neighborhoods based on their level of disadvantage. The study classified the neighborhoods from the least disadvantaged to the most disadvantaged based on socioeconomic factors.
The results of the study revealed a clear trend: individuals living in neighborhoods with higher levels of disadvantage were more likely to develop dementia over time. By the end of the study, 11% of participants in the least disadvantaged neighborhoods had developed Alzheimer’s disease. In comparison, 14% of participants in neighborhoods with moderate disadvantage, 17% in neighborhoods with high disadvantage, and 22% in the most disadvantaged neighborhoods had developed dementia.
After adjusting for other risk factors such as age, sex, and education, the study found that individuals living in the most disadvantaged neighborhoods were more than twice as likely to develop dementia as those living in neighborhoods with the least disadvantage.
The study also highlighted racial disparities in the distribution of neighborhood disadvantage. A higher percentage of Black participants resided in neighborhoods with greater socioeconomic disadvantage, while more White participants lived in neighborhoods with lower levels of disadvantage. However, once neighborhood disadvantage was factored into the analysis, the racial difference in dementia risk diminished. In other words, when controlling for neighborhood factors, there was no significant difference in the risk of developing Alzheimer’s between Black and White participants.
In addition to assessing dementia development, the researchers also measured the annual rate of cognitive decline among the participants, using tests of memory and thinking skills. The results revealed that people living in the most disadvantaged neighborhoods experienced cognitive decline at a rate approximately 25% faster than those living in neighborhoods with the least disadvantage. This suggests that not only does neighborhood disadvantage contribute to a higher likelihood of dementia, but it may also accelerate cognitive decline in those at risk.
While the study provides valuable insights, it is important to note that all participants lived in neighborhoods within Chicago, which may limit the generalizability of the findings to other populations or geographic locations. Further research would be needed to determine whether similar patterns of neighborhood disadvantage and dementia risk exist in other regions.
The study’s findings underscore the need for a broader approach to dementia prevention, one that extends beyond individual factors to include community-level interventions. By addressing the underlying socioeconomic disparities in neighborhoods, it may be possible to reduce dementia risk and improve cognitive health outcomes for older adults in disadvantaged communities.
In summary, the study highlights a significant association between living in disadvantaged neighborhoods and an increased risk of dementia, with individuals in the most disadvantaged areas being more likely to develop Alzheimer’s disease and experience faster cognitive decline. While the study does not establish a causal relationship, it offers compelling evidence that neighborhood factors play a crucial role in shaping cognitive health in older adults. Prioritizing resources and support for disadvantaged communities may provide a promising avenue for reducing dementia risk on a larger scale.
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