Exposure to neighborhood concentrated poverty is associated with faster decline in episodic memory among midlife women

Abstract

Introduction: Neighborhood-level socioeconomic status (nSES) is associated with risk for cognitive impairment, but prior studies assessed nSES within an individual's own residential area without considering the distribution of nSES among adjacent areas.

Methods: Using up to 14 years of data from the Study of Women's Health Across the Nation (N = 1391, mean age = 54), we examined whether geographic clustering of concentrated neighborhood poverty was associated with cognitive decline over midlife.

Results: Greater neighborhood concentrated poverty was associated with faster decline in episodic memory but not in processing speed or working memory. Living in high concentrated poverty areas was linked to a 7% episodic memory decline per decade (both immediate and delayed recall), with Black women experiencing the steepest decline at 10% per decade (delayed recall).

Discussion: Women living in concentrated poverty areas exhibited accelerated decline in episodic memory during midlife. Neighborhood concentrated poverty may impact risk for future cognitive impairment and ADRD.

Highlights: Living in concentrated poverty areas predicted a more rapid episodic memory decline. This pattern was most pronounced among Black women. The cohort was a racially/ethnically diverse cohort of midlife women across the US. Neighborhood concentrated poverty may contribute to the risk of ADRD.

Keywords: cognitive decline; delayed recall; episodic memory; hot spots analysis; immediate recall; longitudinal analysis; midlife; neighborhood concentrated poverty; race; socioeconomic.

FIGURE 1

Spatial distribution of high concentrated poverty (i.e., red areas) and low concentrated poverty (i.e., blue areas) located throughout each SWAN site in 2003.

FIGURE 2

Predicted levels and rates of change in cognitive performance by neighborhood concentrated poverty.