Neighborhood not associated with subjective cognitive decline in Black women

Key takeaways:

• The research analyzed 20,768 individuals from the Black Women’s Health Study.
• Differences in degree of subjective cognitive function across quintiles were not statistically significant.

DENVER – Location of residence was not associated with subjective cognitive decline in Black women, suggesting the Area Deprivation Index may not be a reliable measurement, according to a speaker.

“Systems interact with one another ultimately to influence how to cross the life course,” Tanisha Hill-Jarrett, PhD, assistant professor in the memory & aging center of the department of neurology at the University of California San Francisco, stated in her presentation at the American Academy of Neurology annual meeting. “Spatialized patterning of health has been examined in relationship to neighborhood as well as neighborhood disadvantage.”

Hill-Jarrett aimed to examine associations between the disadvantage of residing in certain neighborhoods and subjective cognitive decline (SCD) in Black women, given that prior research revealed that Black women are more likely to live in resource-deprived areas and established SCD as a valid prodromal marker of dementia.

She compiled data from the Black Women’s Health Study, a biennial prospective cohort study featuring more than 59,000 Black women between the ages of 21 and 69 years, to include 20,768 individuals (mean age 64.63 years).

All participants were given a six-item questionnaire derived from the Structured Telephone Interview for Dementia Assessment (STIDA), which categorized attitude towards cognitive functioning as either good (0 concerns), moderate (1-2 concerns) or poor (3 or more concerns). Population analysis was performed by the Area Deprivation Index (ADI), which comprised 17 variables derived from available census data, for the years 2011 to 2015, from the American Community Survey.

The 2015 ADI was then linked to census groups for the years 2012 to 2015 and subsequently reconfigured to represent quartiles at the state level, where the first quintile represented those least disadvantaged, and the fifth quintile represented those most disadvantaged.

Mutinomial logistic regression was employed with 95% confidence intervals for moderate and poor compared with good view of cognition and divided into four sections: an unadjusted model, then adjusting for age and early-life factors such as education and receipt of public assistance, adjusting for level of education (less than 12 years, 12 years or more than 12 years) attained, and also for several behavioral and clinical risk factors (BMI, physical activity, diabetes/hypertension, tobacco use, depression, insomnia and receipt of public assistance as an adult).

According to results, ADI was not associated with SCD in Black women, after accounting for education, while Hill-Jarrett hypothesized that educational attainment may be influenced by neighborhood of residence.

Data also showed the fewest number of participants resided in the least (n = 3,541) and most disadvantaged (n = 3,980) quartiles, with differences in the degree of subjective cognitive function across all quintiles not statistically significant.

“Perhaps the metric of ADI is not capturing what we need, specifically for Black women,” Hill-Jarrett said. “There needs to be additional work exploring the role of education; it’s not clear from the analysis.”