Health Disparities
Life-course Trajectories of Neighborhood Deprivation and Cognitive Consequences in Midlife: The Bogalusa Heart Study Eunsun Gill* Eunsun Gill Gill Gill Gill Gill Gill Gill Gill Gill Gill Gill Gill Tulane University School of Public Health and Tropical Medicine
Introduction: Neighborhood socioeconomic deprivation contributes to cognitive function (CF) in middle-aged and older adults, yet life-course and longitudinal patterns remain understudied. We examined associations of cumulative and trajectory-based Area Deprivation Index (ADI) with midlife CF in the Bogalusa Heart Study.
Methods: We analyzed 1,052 adults (61% White, 39% Black; mean age at CF: 48±5.3). Residential addresses (1974–2016) were geocoded and linked to 17 census-based indicators. ADI was derived using weighted principal component analysis, with census/American Community Survey data (1990, 2000, 2006–2010, and 2013–2017) matched to address and year. Latent class growth curve models identified ADI trajectories, and cumulative ADI was estimated using the trapezoidal method. CF domains were age- and sex-standardized. Linear regression models estimated associations of cumulative and trajectory-based ADI with CF, adjusting for race, sex, parental education, adult education, and income. Multiple imputation was used to adjust for bias due to missing at random variables.
Results: Three ADI trajectories were identified: high-steady, middle-steady, and low-to-moderate increasing deprivation. Compared with the low-to-moderate increasing deprivation, high- and middle-steady deprivation had lower global CF (β= –0.36 [95% CI: –0.54, –0.18] and –0.23 [–0.41, –0.05]) and poorer verbal episodic memory and attention. The largest differences were observed in working memory (high: –0.47 [–0.71, –0.23]; middle: –0.30 [–0.50, –0.10]). No associations were found for processing speed. Cumulative ADI was inversely associated with global CF (–0.06 [–0.02, –0.10]), working memory (–0.07 [–0.13, –0.01]), and processing speed (–0.12 [–0.20, –0.04]), but not with verbal episodic memory.
Conclusions: Persistent high neighborhood deprivation and greater cumulative exposure across the life course were associated with poorer midlife CF, particularly working memory.
