PMID- 37647071 OWN - NLM STAT- MEDLINE DCOM- 20230831 LR - 20240328 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 6 IP - 8 DP - 2023 Aug 1 TI - Evaluation of Neighborhood-Level Disadvantage and Cognition in Mexican American and Non-Hispanic White Adults 50 Years and Older in the US. PG - e2325325 LID - 10.1001/jamanetworkopen.2023.25325 [doi] LID - e2325325 AB - IMPORTANCE: Understanding how socioeconomic factors are associated with cognitive aging is important for addressing health disparities in Alzheimer disease. OBJECTIVE: To examine the association of neighborhood disadvantage with cognition among a multiethnic cohort of older adults. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, data were collected between September 1, 2017, and May 31, 2022. Participants were from the Health and Aging Brain Study-Health Disparities, which is a community-based single-center study in the Dallas/Fort Worth area of Texas. A total of 1614 Mexican American and non-Hispanic White adults 50 years and older were included. EXPOSURE: Neighborhood disadvantage for participants' current residence was measured by the validated Area Deprivation Index (ADI); ADI Texas state deciles were converted to quintiles, with quintile 1 representing the least disadvantaged area and quintile 5 the most disadvantaged area. Covariates included age, sex, and educational level. MAIN OUTCOMES AND MEASURES: Performance on cognitive tests assessing memory, language, attention, processing speed, and executive functioning; measures included the Spanish-English Verbal Learning Test (SEVLT) Learning and Delayed Recall subscales; Wechsler Memory Scale, third edition (WMS-III) Digit Span Forward, Digit Span Backward, and Logical Memory 1 and 2 subscales; Trail Making Test (TMT) parts A and B; Digit Symbol Substitution Test (DSST); Letter Fluency; and Animal Naming. Raw scores were used for analyses. Associations between neighborhood disadvantage and neuropsychological performance were examined via demographically adjusted linear regression models stratified by ethnic group. RESULTS: Among 1614 older adults (mean [SD] age, 66.3 [8.7] years; 980 women [60.7%]), 853 were Mexican American (mean [SD] age, 63.9 [7.9] years; 566 women [66.4%]), and 761 were non-Hispanic White (mean [SD] age, 69.1 [8.7] years; 414 women [54.4%]). Older Mexican American adults were more likely to reside in the most disadvantaged areas (ADI quintiles 3-5), with 280 individuals (32.8%) living in ADI quintile 5, whereas a large proportion of older non-Hispanic White adults resided in ADI quintile 1 (296 individuals [38.9%]). Mexican American individuals living in more disadvantaged areas had worse performance than those living in ADI quintile 1 on 7 of 11 cognitive tests, including SEVLT Learning (ADI quintile 5: beta = -2.50; 95% CI, -4.46 to -0.54), SEVLT Delayed Recall (eg, ADI quintile 3: beta = -1.11; 95% CI, -1.97 to -0.24), WMS-III Digit Span Forward (eg, ADI quintile 4: beta = -1.14; 95% CI, -1.60 to -0.67), TMT part A (ADI quintile 5: beta = 7.85; 95% CI, 1.28-14.42), TMT part B (eg, ADI quintile 5: beta = 31.5; 95% CI, 12.16-51.35), Letter Fluency (ADI quintile 4: beta = -2.91; 95% CI, -5.39 to -0.43), and DSST (eg, ADI quintile 5: beta = -4.45; 95% CI, -6.77 to -2.14). In contrast, only non-Hispanic White individuals living in ADI quintile 4 had worse performance than those living in ADI quintile 1 on 4 of 11 cognitive tests, including SEVLT Learning (beta = -2.35; 95% CI, -4.40 to -0.30), SEVLT Delayed Recall (beta = -0.95; 95% CI, -1.73 to -0.17), TMT part B (beta = 15.95; 95% CI, 2.47-29.44), and DSST (beta = -3.96; 95% CI, -6.49 to -1.43). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, aging in a disadvantaged area was associated with worse cognitive functioning, particularly for older Mexican American adults. Future studies examining the implications of exposure to neighborhood disadvantage across the life span will be important for improving cognitive outcomes in diverse populations. FAU - Wong, Christina G AU - Wong CG AD - Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada. FAU - Miller, Justin B AU - Miller JB AD - Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada. FAU - Zhang, Fan AU - Zhang F AD - Institute for Translational Research, University of North Texas Health Science Center, Fort Worth. AD - Department of Family Medicine, University of North Texas Health Science Center, Fort Worth. FAU - Rissman, Robert A AU - Rissman RA AD - Department of Neurosciences, University of California, San Diego, La Jolla. AD - Veterans Affairs San Diego Healthcare System, San Diego, California. FAU - Raman, Rema AU - Raman R AD - Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego. FAU - Hall, James R AU - Hall JR AD - Institute for Translational Research, University of North Texas Health Science Center, Fort Worth. FAU - Petersen, Melissa AU - Petersen M AD - Institute for Translational Research, University of North Texas Health Science Center, Fort Worth. AD - Department of Family Medicine, University of North Texas Health Science Center, Fort Worth. FAU - Yaffe, Kristine AU - Yaffe K AD - Department of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California, San Francisco. AD - San Francisco VA Medical Center, San Francisco, California. FAU - Kind, Amy J AU - Kind AJ AD - Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison. AD - Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison. FAU - O'Bryant, Sid E AU - O'Bryant SE AD - Institute for Translational Research, University of North Texas Health Science Center, Fort Worth. CN - HABS-HD Study Team LA - eng GR - P20 GM109025/GM/NIGMS NIH HHS/United States GR - U19 AG078109/AG/NIA NIH HHS/United States GR - R35 AG071916/AG/NIA NIH HHS/United States GR - P20 AG068053/AG/NIA NIH HHS/United States GR - R01 AG058533/AG/NIA NIH HHS/United States GR - R01 AG070883/AG/NIA NIH HHS/United States GR - RF1 AG057784/AG/NIA NIH HHS/United States GR - R01 AG054073/AG/NIA NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20230801 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM MH - Female MH - Humans MH - *Cognition MH - Cross-Sectional Studies MH - Executive Function MH - *Mexican Americans MH - *White MH - Male MH - Middle Aged MH - Aged MH - *Neighborhood Characteristics MH - United States PMC - PMC10469291 COIS- Conflict of Interest Disclosures: Dr Raman reported receiving grants from the National Institute on Aging (NIA) during the conduct of the study and grants from the Alzheimer's Association, the American Heart Association, Eisai Co, and Eli Lilly and Company outside the submitted work. Dr Yaffe reported receiving personal fees from Alector, Alpha Cognition, and Eli Lilly and Company; and service duties on data safety monitoring boards for National Institutes of Health-sponsored studies outside the submitted work. Dr Kind reported receiving grants from the National Institutes of Health during the conduct of the study and outside the submitted work. Dr O'Bryant reported receiving personal fees from Cx Precision Medicine, owning multiple patents on precision medicine for neurodegenerative diseases that have been licensed to Cx Precision Medicine, and serving on advisory boards for Eisai Co outside the submitted work. No other disclosures were reported. FIR - Ances, Beau IR - Ances B FIR - Babulal, Ganesh IR - Babulal G FIR - Barber, Robert IR - Barber R FIR - Barnes, Lisa IR - Barnes L FIR - Borzage, Matthew IR - Borzage M FIR - Braskie, Meredith IR - Braskie M FIR - Cheema, Amrita IR - Cheema A FIR - Christian, Brad IR - Christian B FIR - Cohen, Ann IR - Cohen A FIR - Donohue, Michael IR - Donohue M FIR - Hall, James IR - Hall J FIR - Johnson, Leigh IR - Johnson L FIR - Kind, Amy IR - Kind A FIR - Large, Stephanie IR - Large S FIR - Lee, Joe IR - Lee J FIR - Llibre-Guerra, Jorge IR - Llibre-Guerra J FIR - Mapstone, Mark IR - Mapstone M FIR - Mason, David IR - Mason D FIR - Mielke, Michelle IR - Mielke M FIR - Nandy, Rajesh IR - Nandy R FIR - O'Bryant, Sid IR - O'Bryant S FIR - Okonkwo, Ozioma IR - Okonkwo O FIR - Palmer, Ray IR - Palmer R FIR - Petersen, Melissa IR - Petersen M FIR - Phillips, Nicole IR - Phillips N FIR - Raman, Rema IR - Raman R FIR - Rissman, Robert IR - Rissman R FIR - Rivera Mindt, Monica IR - Rivera Mindt M FIR - Shi, Yonggang IR - Shi Y FIR - Toga, Arthur IR - Toga A FIR - Vardarajan, Badri IR - Vardarajan B FIR - Vintimilla, Raul IR - Vintimilla R FIR - Yaffe, Kristine IR - Yaffe K FIR - Zhang, Fan IR - Zhang F FIR - Zhou, Zhengyang IR - Zhou Z EDAT- 2023/08/30 12:42 MHDA- 2023/08/31 06:41 PMCR- 2023/08/30 CRDT- 2023/08/30 11:34 PHST- 2023/08/31 06:41 [medline] PHST- 2023/08/30 12:42 [pubmed] PHST- 2023/08/30 11:34 [entrez] PHST- 2023/08/30 00:00 [pmc-release] AID - 2808934 [pii] AID - zoi230735 [pii] AID - 10.1001/jamanetworkopen.2023.25325 [doi] PST - epublish SO - JAMA Netw Open. 2023 Aug 1;6(8):e2325325. doi: 10.1001/jamanetworkopen.2023.25325.