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Updated: Feb 11, 2026
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Published on: May 5, 2015
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Social determinants of brain structure and cognition
Mahsa Mayeli1, David Matuskey2,
1Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA.
Social Science & Medicine (1982)
|February 9, 2026
Summary
Neighborhood disadvantage is linked to cognitive decline and brain structure differences in older adults. These associations suggest environmental factors influence cognition beyond neurodegeneration.
Area of Science:
- Neuroscience
- Public Health
- Gerontology
Background:
- Socioeconomic disadvantage is a known risk factor for cognitive decline.
- Neural pathways linking disadvantage to cognitive decline are not well understood.
- The Area Deprivation Index (ADI) measures neighborhood disadvantage.
Purpose of the Study:
- To investigate the association between neighborhood disadvantage (ADI) and cognitive performance in older adults, mild cognitive impairment (MCI), and Alzheimer's disease (AD).
- To determine if structural brain differences mediate the relationship between ADI and cognition.
Main Methods:
- 822 older adults (cognitively unimpaired [CU], MCI, AD) were included.
- Regression models assessed associations between ADI, cognition, and brain structure, adjusting for age and sex.
- Mediation analyses explored the role of total brain volume in the ADI-cognition relationship.
Main Results:
- Higher ADI correlated with poorer cognitive performance in CU and MCI individuals.
- ADI was linked to smaller total brain volumes and greater white matter hyperintensity in CU.
- Total brain volume partially mediated the association between ADI and language performance.
Conclusions:
- Neighborhood disadvantage is associated with cognitive vulnerability and brain structure changes.
- Brain volume explains a limited portion of the link between disadvantage and cognition.
- Environmental and contextual factors likely influence cognitive performance through pathways beyond structural neurodegeneration.
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