Abstract / Summary
Socioeconomic disadvantage (SED) has been associated with poorer brain health, yet its underlying pathology remains incompletely understood. We examined whether neighborhood-level SED, measured using the Area Deprivation Index (ADI), relates to amyloid deposition assessed with amyloid positron emission tomography (PET). Participants ( n = 1110) underwent cognitive assessment using the mini mental state examination (MMSE) and PET scanning with amyloid-specific tracers. Associations between national and state ADI and MMSE and global amyloid burden were evaluated using linear models adjusting for age, sex, and APOE-ε4 carrier status. Higher ADI was associated with lower MMSE scores, with both national and state measures showing significant inverse associations independent of age and sex (all p < 0.001). Higher ADI was also significantly associated with greater amyloid burden among cognitively unimpaired participants ( β = 0.18, p = 0.006, d = 0.27). No mediation effect with centiloids was observed between ADI and MMSE in the analysis, however. Neighborhood socioeconomic disadvantage is associated with worse cognitive performance and for the first time were shown to be associated with amyloid accumulation. These findings underscore the need to consider socioeconomic context in early-stage risk assessment and may help inform targeted prevention strategies aimed at reducing disparities in dementia outcomes.