Differential associations of neighborhood disadvantage, race/ethnicity, and cognitive status with experiences of psychosocial distress in the HABS-HD cohort

Abstract

INTRODUCTION: Understanding how contextual socioeconomic factors are associated with psychosocial distress among different ethnoracial groups is important for addressing health disparities in individuals at risk for Alzheimer's disease. METHODS: Using Health and Aging Brain Study–Health Disparities (HABS-HD) data collected between 2017 and 2023, we examined the association of neighborhood disadvantage with psychosocial distress using demographically adjusted linear regression models, stratified by ethnoracial group and cognitive status. RESULTS: We included 630 non-Hispanic Black, 1109 Hispanic, and 1068 non-Hispanic White older adults deemed cognitively normal (CN) or diagnosed with mild cognitive impairment (MCI). Residing in areas of greater neighborhood disadvantage was associated with increased chronic stress (CS) among CN White participants, but this relationship was attenuated among White participants with MCI. Regardless of cognitive status, severe levels of disadvantage were associated with increased CS and depression among Black participants. DISCUSSION: Aging in more disadvantaged neighborhoods was associated with greater CS and depression for Black and White participants. Highlights: Greater neighborhood disadvantage was associated with increased depression and chronic stress for White and Black individuals. Individuals with mild cognitive impairment reported greater levels of psychosocial distress. These findings are relevant for addressing mental health inequity in aging populations.