Income, Race-Ethnicity, and Dementia Risk Factors in the United States
Eric L Stulberg1,2, Chaorong Wu3, Connor A Law1
1Department of Neurology, University of Pennsylvania, Philadelphia.
Neurology
|November 12, 2025
Summary
Lower income and underrepresented race-ethnicity are linked to higher dementia risk factors. Targeted prevention in these groups could improve dementia risk reduction efforts.
Area of Science:
- Public Health
- Epidemiology
- Gerontology
Background:
- Dementia risk is influenced by modifiable factors.
- Socioeconomic status and race-ethnicity may impact dementia risk.
- Understanding these disparities is crucial for effective prevention.
Purpose of the Study:
- To calculate population attributable fractions (PAFs) for modifiable dementia risk factors by income level.
- To examine the independent and interactive effects of race-ethnicity and income on dementia risk factors.
- To assess the association between race-ethnicity, income, and the cumulative number of midlife dementia risk factors.
Main Methods:
- Utilized a nationally representative cross-sectional study design (National Health and Nutrition Examination Surveys, 1999-2018).
- Analyzed data from individuals across early-life, midlife, and late-life age groups.
- Calculated PAFs and prevalence ratios (PR) for 13 dementia risk factors and cumulative risk scores.
Main Results:
- Higher income correlated with lower prevalence of most dementia risk factors, excluding obesity, high LDL, and traumatic brain injury (TBI).
- The highest PAF for individuals below the federal poverty level was late-life vision loss (20.9%).
- Underrepresented race-ethnicity groups showed higher prevalence of midlife diabetes, obesity, physical inactivity, and late-life vision loss.
Conclusions:
- Lower income and historically underrepresented race-ethnicity are significantly associated with numerous dementia risk factors.
- Dementia prevention strategies should prioritize modifiable risk factors within these higher-risk populations.
- Targeted interventions can enhance the success of dementia risk reduction efforts.
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