Association of residential neighborhood disadvantage with amyloid PET positivity among cognitively impaired individuals

TL;DR

Living in a disadvantaged neighborhood may be linked to lower amyloid levels in the brains of people with cognitive issues, according to a study of over 17,000 individuals.

Contribution

This study is the first to link neighborhood disadvantage with amyloid PET positivity in a large, diverse sample of cognitively impaired individuals.

Findings

Residence in the most disadvantaged neighborhoods was associated with lower odds of amyloid PET positivity by visual interpretation.

The association was not significant when using PET Centiloid values as the measure of amyloid pathology.

The study included a diverse population, with 535 participants from the most disadvantaged neighborhoods.

Abstract

Relationships between Alzheimer’s disease neuropathology, residential neighborhood, and cognitive impairment remain incompletely understood.

We examined whether residence within a disadvantaged neighborhood was associated with amyloid positron emission tomography (PET) positivity. We used data from the observational, multisite, Imaging Dementia–Evidence for Amyloid Scanning study that included cognitively impaired Medicare beneficiaries. Our secondary analysis examined multivariable-adjusted associations between neighborhood disadvantage (measured by Area Deprivation Index [ADI] deciles 1–90 vs. 91–100 representing greatest disadvantage) and amyloid PET positivity.

Among 15,346 White, 829 Latino, 637 Black/African American, and 321 Asian individuals, 51% were female, mean age was 75.7 years, 535 (3.8%) resided in ADI 91 to 100 decile, and 61.6% were amyloid PET positive. The ADI 91–100 decile was associated with lower odds of PET positivity by visual interpretation (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.67–0.96, p ≤ .001) but not PET Centiloid value ≥ 40 versus ≤ 10 (OR 0.81, 95% CI 0.66–1.01, p = 0.060).

Residence in the most disadvantaged neighborhoods may be associated with lower amyloid pathology in cognitively impaired individuals.