Sex-specific association between neighborhood characteristics and dementia: The Three-City cohort

Abstract

Introduction: The living environment affects general health and may influence cognitive aging; however, the relationships between neighborhood characteristics and dementia are still poorly understood. Methods: We used data from a French population–based prospective study (the Three-City cohort) that included 7016 participants aged 65 years and older with a 12-year follow-up. We used principal components analysis of neighborhood composition indicators to construct the Three-City deprivation score. To study its impact on dementia incidence, we performed survival analyses using a marginal Cox model to take into account intraneighborhood correlations. As interaction with sex was significant, analyses were stratified by sex. Results: Even after controlling on individual factors, women living in deprived neighborhoods were at higher risk of dementia (hazard ratio = 1.29, 95% confidence interval 1.00–1.67) and Alzheimer's disease (hazard ratio = 1.42, 95% confidence interval 1.09–1.84). No association was found for men. Discussion: Living in a deprived neighborhood is associated with higher risk of dementia in women.