Taylor M Mobley1, Crystal Shaw1,2, Eleanor Hayes-Larson1, Joseph Fong1, Paola Gilsanz3,4, Gilbert C Gee5, Ron Brookmeyer2, Rachel A Whitmer3,6,7, Joan A Casey8, Elizabeth Rose Mayeda1,4. 1. Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California, USA. 2. Department of Biostatistics, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California, USA. 3. Kaiser Permanente Division of Research, Oakland, California, USA. 4. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA. 5. Department of Community Health Sciences, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California, USA. 6. Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California, USA. 7. Alzheimer's Disease Center, University of California Davis Health, Sacramento, California, USA. 8. Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA.
Abstract
INTRODUCTION: Some evidence suggests that neighborhood socioeconomic disadvantage is associated with dementia-related outcomes. However, prior research is predominantly among non-Latino Whites. METHODS: We evaluated the association between neighborhood disadvantage (Area Deprivation Index [ADI]) and dementia incidence in Asian American (n = 18,103) and non-Latino White (n = 149,385) members of a Northern California integrated health care delivery system aged 60 to 89 at baseline. Race/ethnicity-specific Cox proportional hazards models adjusted for individual-level age, sex, socioeconomic measures, and block group population density estimated hazard ratios (HRs) for dementia. RESULTS: Among non-Latino Whites, ADI was associated with dementia incidence (most vs. least disadvantaged ADI quintile HR = 1.09, 95% confidence interval [CI] = 1.02-1.15). Among Asian Americans, associations were close to null (e.g., most vs. least disadvantaged ADI quintile HR = 1.01, 95% CI = 0.85-1.21). DISCUSSION: ADI was associated with dementia incidence among non-Latino Whites but not Asian Americans. Understanding the potentially different mechanisms driving dementia incidence in these groups could inform dementia prevention efforts.
INTRODUCTION: Some evidence suggests that neighborhood socioeconomic disadvantage is associated with dementia-related outcomes. However, prior research is predominantly among non-Latino Whites. METHODS: We evaluated the association between neighborhood disadvantage (Area Deprivation Index [ADI]) and dementia incidence in Asian American (n = 18,103) and non-Latino White (n = 149,385) members of a Northern California integrated health care delivery system aged 60 to 89 at baseline. Race/ethnicity-specific Cox proportional hazards models adjusted for individual-level age, sex, socioeconomic measures, and block group population density estimated hazard ratios (HRs) for dementia. RESULTS: Among non-Latino Whites, ADI was associated with dementia incidence (most vs. least disadvantaged ADI quintile HR = 1.09, 95% confidence interval [CI] = 1.02-1.15). Among Asian Americans, associations were close to null (e.g., most vs. least disadvantaged ADI quintile HR = 1.01, 95% CI = 0.85-1.21). DISCUSSION: ADI was associated with dementia incidence among non-Latino Whites but not Asian Americans. Understanding the potentially different mechanisms driving dementia incidence in these groups could inform dementia prevention efforts.
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