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Aging in disadvantaged neighborhoods may worsen age-related cognitive problems, especially among Mexican Americans

Aging in a more disadvantaged neighborhood may worsen a person’s performance on cognitive tests, particularly if that individual is Mexican American. Findings from the NIA-funded study were published in JAMA Network Open.

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A team of researchers from the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, University of North Texas Health Science Center in Fort Worth, and other institutions analyzed data from 1,614 participants age 50 years or older in the Health and Aging Brain Study — Health Disparities. More than half of the participants identified as Mexican American, with the rest non-Hispanic White, and were on average age 66. To measure cognition, the researchers examined performance on cognitive tests assessing memory, language, attention, processing speed, and executive functioning. Neighborhood disadvantage of each participant’s current residence was characterized using the Area Deprivation Index, which uses indicators of poverty, education, housing, and employment.

Mexican American participants were more likely to live in more disadvantaged areas, whereas a greater proportion of non-Hispanic White participants lived in less disadvantaged areas. Eighty Mexican American and 46 non-Hispanic White participants received a dementia diagnosis.

After adjusting for age, educational level, and sex, the researchers found an association between neighborhood disadvantage and cognitive performance for both groups of participants. This effect was enhanced for the Mexican American participants. Mexican Americans living in the three most disadvantaged neighborhoods performed worse on tests of memory, attention, processing speed, and executive function than those living in the least disadvantaged neighborhood category. In contrast, non-Hispanic White participants who lived in the fourth most disadvantaged neighborhood performed worse than those living in the least disadvantaged neighborhood category on tests of memory, executive function, and processing speed.

Neighborhood disadvantage, the researchers point out, is a risk factor that can be changed, although not easily. The different association of neighborhood disadvantage with cognition among older Mexican American and non-Hispanic White adults likely relates to an interplay of individual, socioeconomic, sociopolitical, and environmental factors that affect different racial and ethnic groups. Continuing to identify and understand these factors is important for improving aging outcomes among diverse populations. The study findings also suggest that moderately disadvantaged neighborhoods, as well as the most disadvantaged, would likewise benefit from intervention.

The small number of non-Hispanic White participants living in the most disadvantaged neighborhoods may have been a limitation for the analysis. Additional research could explore which types of cognitive functioning are most often associated with neighborhood disadvantage. The research will continue with follow-up analysis of this group of participants and will additionally include a group of African American participants.

This research was supported in part by NIA grants R01AG054073, R01AG058533, U19AG078109, P20AG068053, R01AG070883, and RF1AG057784.

These activities relate to NIH’s Alzheimer’s and Related Dementias Research Implementation Milestones:

  • 1.C, “Continue to establish new cohorts that include participants across diverse racial, ethnic and socioeconomic backgrounds and incorporate the collection of multi-omic and clinical data (imaging, personal wearables, and sensors for in-home monitoring) to accelerate the identification of genomic variants and other risk and protective factors contributing to the heterogeneity and multifactorial etiology of dementia and to enable the development of predictive models of disease and wellness.”
  • 1.I, “Identify life course and multi-level mechanisms of and pathways to AD/ADRD inequities and use the discoveries to reduce these inequities.”
  • 2.J, “Expand research on the role of social and psychosocial factors on AD risk and resilience to risk in ethnically and socioeconomically diverse populations to interrogate mechanisms of disparities in health burden of AD, and inform intervention strategies and public health policy.”


Wong CG, et al. Evaluation of neighborhood-level disadvantage and cognition in Mexican American and non-Hispanic White adults 50 years and older in the US. JAMA Network Open. 2023;6(8):e2325325. doi: 10.1001/jamanetworkopen.2023.25325.

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