![]() Obtained funding: Rissman, Okonkwo, Johnson, Kind, Bendlin.Īdministrative, technical, or material support: Oh, Vogt, Rissman, Kind. Hunt, Zuelsdorff, Powell, Norton, Rissman, Asthana, Okonkwo, Johnson, Kind, Bendlin. Hunt, Buckingham, Kim, Vogt, Jonaitis, T. ![]() Hunt, Oh, Zuelsdorff, Kind.Ĭritical revision of the manuscript for important intellectual content: J. Hunt, Buckingham, Kim, Oh, Vogt, Jonaitis, Zuelsdorff, Powell, Norton, Rissman, Asthana, Okonkwo, Kind, Bendlin.ĭrafting of the manuscript: J. Hunt, Powell, Rissman, Johnson, Kind, Bendlin.Īcquisition, analysis, or interpretation of data: J. Middleton Hospital Department of Veterans Affairs, 2500 Overlook Terr, Madison, WI 53705 ( Contributions: Mr Hunt and Dr Bendlin had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.Ĭoncept and design: J. Kind, MD, PhD, Geriatric Research Education and Clinical Center, William S. Bendlin, PhD, Clinical Science Center, University of Wisconsin–Madison, 600 Highland Ave, J5/Mezzanine, Madison, WI 53719 ( Amy J. Cardiovascular risk mediated this association for total brain tissue volume but not for hippocampal volume, suggesting that neighborhood-level disadvantage may be associated with these 2 outcomes via distinct biological pathways.Ĭorresponding Authors: Barbara B. This finding suggests an association of community socioeconomic context, distinct from individual-level socioeconomic status, with brain volume during aging. Cardiovascular risk score, examined in a subsample of 893 participants, mediated this association for total brain tissue but not for hippocampal volume.Conclusions and relevanceFor cognitively unimpaired individuals, living in the most disadvantaged neighborhoods was associated with significantly lower cerebral volumes, after controlling for maximal premorbid (total intracranial) volume. Robust propensity score-matched analyses determined that this association was not due to racial/ethnic or demographic characteristics. Linear regression models were fitted to test associations between relative neighborhood-level disadvantage (highest 20% based on state of residence) and hippocampal and total brain tissue volume, as assessed by magnetic resonance imaging.ResultsIn the primary analysis of 951 participants (637 women mean age, 63.9 years), living in the 20% most disadvantaged neighborhoods was associated with 4.1% lower hippocampal volume (β = -317.44 95% CI, -543.32 to -91.56 P = .006) and 2.0% lower total brain tissue volume (β = -20 959.67 95% CI, -37 611.92 to -4307.43 P = .01), after controlling for intracranial volume, individual-level educational attainment, age, and sex. Statistical analysis was performed from April 3 to September 27, 2019.Main outcomes and measuresThe Area Deprivation Index, a geospatially determined index of neighborhood-level disadvantage, and cardiovascular disease risk indices were calculated for each participant. The cohort was enriched for Alzheimer disease risk based on family history of dementia. ![]() Participants were cognitively unimpaired based on National Institute on Aging-Alzheimer's Association workgroup diagnostic criteria for mild cognitive impairment and Alzheimer disease, confirmed through a consensus diagnosis panel. The association of neighborhood socioeconomic disadvantage with brain volume in this context is not well known.ObjectiveTo test whether neighborhood-level socioeconomic disadvantage is associated with decreased brain volume in a cognitively unimpaired population enriched for Alzheimer disease risk.Design, setting, and participantsThis study, conducted from January 6, 2010, to January 17, 2019, at an academic research neuroimaging center, used cross-sectional data on 951 participants from 2 large, ongoing cohort studies of Alzheimer disease (Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center clinical cohort). ImportanceIdentifying risk factors for brain atrophy during the aging process can help direct new preventive approaches for dementia and cognitive decline.
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