Association of residential neighborhood disadvantage with amyloid PET positivity among cognitively impaired individuals.

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Introduction: Relationships between Alzheimer's disease neuropathology, residential neighborhood, and cognitive impairment remain incompletely understood. Methods: We examined whether residence within a disadvantaged neighborhood was associated with amyloid positron emission tomography (PET) positivity. We used data from the observational, multisite, Imaging Dementia-Evidence for Amyloid Scanning study that included cognitively impaired Medicare beneficiaries. Our secondary analysis examined multivariable-adjusted associations between neighborhood disadvantage (measured by Area Deprivation Index [ADI] deciles 1-90 vs. 91-100 representing greatest disadvantage) and amyloid PET positivity. Results: Among 15,346 White, 829 Latino, 637 Black/African American, and 321 Asian individuals, 51% were female, mean age was 75.7 years, 535 (3.8%) resided in ADI 91 to 100 decile, and 61.6% were amyloid PET positive. The ADI 91-100 decile was associated with lower odds of PET positivity by visual interpretation (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.67-0.96, p ≤ .001) but not PET Centiloid value ≥ 40 versus ≤ 10 (OR 0.81, 95% CI 0.66-1.01, p = 0.060). Conclusion: Residence in the most disadvantaged neighborhoods may be associated with lower amyloid pathology in cognitively impaired individuals.

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