Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR

Rachel L. Peterson, Rebecca Pejak, Kristen M. George, Paola Gilsanz, Michelle Ko, Oanh L. Meyer, Elizabeth Rose Mayeda, Amy Kind, Rachel A. Whitmer

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change. METHODS: Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66–100; adulthood ADI 5-99). Interactions by race tested. RESULTS: More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002). DISCUSSION: Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.

Original languageEnglish
JournalAlzheimer's and Dementia
Early online dateOct 10 2023
DOIs
StatePublished - 2023

Keywords

  • health disparities
  • social determinants
  • social epidemiology
  • structural racism

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