Study ties neighborhood deprivation to cognition and amyloid buildup in ADNI cohort

An observational analysis of 1,110 Alzheimer's Disease Neuroimaging Initiative participants found that people living in more economically deprived neighborhoods scored lower on a standard cognition test and, among those without cognitive impairment, had more amyloid on PET scans. The findings do not show that neighborhood conditions cause amyloid to build up.

Residents of more economically deprived neighborhoods showed worse scores on a standard cognitive test and, among those who were cognitively unimpaired, higher levels of amyloid protein on brain scans, according to a study published online October 7, 2026 in npj Dementia. The paper, by Mahsa Mayeli, Riya Saraiya, David Matuskey and colleagues, is a cross-sectional analysis of 1,110 participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) who had both a home-address-based deprivation score and an amyloid PET scan on file.

The researchers used the Area Deprivation Index (ADI), a census-derived measure of neighborhood poverty, education, housing quality and employment, calculated both as a national percentile and a state decile. Higher ADI at both levels was associated with lower scores on the Mini-Mental State Examination (MMSE), independent of age and sex (p less than 0.001 for both measures). Among the subset of participants who were cognitively unimpaired at the time of scanning, higher national ADI was also associated with greater amyloid burden on PET, measured in centiloids (beta = 0.18, p = 0.006, effect size d = 0.27); state ADI showed a similar association (beta = 1.38, p = 0.01). All models adjusted for age, sex and APOE epsilon4 carrier status. Across the full sample, 32.8 percent of participants were amyloid-positive using a centiloid cutoff of 10.

No significant link between ADI and amyloid burden appeared in participants who already had cognitive impairment, which the authors suggest could reflect a ceiling effect once amyloid pathology is already advanced. The authors describe this as the first study to connect the Area Deprivation Index directly to amyloid PET measurements, building on earlier work that tied neighborhood disadvantage to autopsy-confirmed Alzheimer's pathology and to amyloid PET positivity in separate cohorts of cognitively impaired Medicare beneficiaries, with those prior studies reporting mixed results depending on how amyloid positivity was defined.

The authors say the pattern, if confirmed, points toward considering socioeconomic context in early-stage risk assessment, though they stop short of proposing any clinical or policy response and note the association does not establish how neighborhood conditions might relate to amyloid biology.