Neighborhood Brain Health Disparities in Older Adults Presenting for Outpatient Neuropsychological Evaluation

Objective: To understand community-based brain health disparities, we investigated demographic and neuropsychological differences by neighborhood disadvantage in older patients presenting for neuropsychological evaluation. Method: This retrospective chart review calculated patients’ (N=529, Mage=73.5±8.0, Meducation=13.5±3.2, %female=61.8, %White=86.8, %non-Hispanic=95.3) state-level Area Deprivation Index (ADI) to compare patients from the 20% most disadvantaged (n=61) to the 80% least disadvantaged areas (n=468). Results: Patients from disadvantaged areas were less likely to access care (11.5% of sample), had lower educational attainment (p<.001, Cohen’s d=.60), and were more likely to require a medical interpreter (p<.001, Cramer’s V=.17). They had lower premorbid baselines (p<.001, Cohen’s d=.52), performed worse on tests of processing speed (ps=.019-.031, Cohen’s ds=.29-.36), attention (p<.001, Cohen’s d=.47), and executive functioning (p=.047, Cohen’s d=.23), and endorsed more depressive symptoms (p=.027, Cohen’s d=.33). Conclusions: Findings highlight the need for targeted outreach, culturally responsive care, and community-based brain health initiatives to foster cognitive resilience and equitable care access. notReviewed other