[Resource] Social determinants of health and risk of dementia among older men and women: A 12-year cohort study in Australia

INTRODUCTION
Social determinants of health (SDH) are recognized as contributing factors to cognitive disorders, but their collective influence on dementia risk remains unclear.
METHODS
A gender-disaggregated analysis was conducted on 12,896 community-dwelling older Australians (mean ± SD age: 75.2 ± 4.3 years; 54% women) without major cognitive impairment upon enrollment. Latent class analysis identified clusters from 72 SDH (70 individual-level and 2 neighborhood-level), while Cox proportional hazards regression estimated dementia risk over 12 years (median: 8.4) follow-up.
RESULTS
Four clusters were identified: least disadvantaged (Class 1: 31.5% men; 30.6% women), most disadvantaged (Class 2: 20.2% men; 19.4% women), high social support with Class 1 features (Class 3: 22.2% men; 24.1% women), and high social support with Class 2 features (Class 4: 26.1% men; 25.7% women). Compared to Class 1, men (HR: 1.49, 95% CI: 1.12–1.98) and women (HR: 1.56, 95% CI: 1.17–2.07) in Class 2, and women in Class 4 (HR: 1.66, 95% CI: 1.28–2.16) had a higher dementia risk.
DISCUSSION
Socioeconomic disadvantage was associated with incident dementia. Despite stronger social support, women's cognitive capacity appeared to be disproportionately impacted by adverse SDH.
Highlights
- Four distinct multidimensional clusters were identified from a wide range of 72 social determinants of health.
- These clusters were associated with dementia risk differently in men and women.
- In both men and women, the most socioeconomically disadvantaged group had a higher risk of dementia.
- Despite stronger interpersonal social support, women had a greater risk of dementia.
- The addition of known dementia risk factors in cluster analysis did not change the findings, suggesting that social determinants of health independently predict dementia risk.
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By
Alzheimer's Assocation
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Published
Mar 24, 2025
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Subject Area
- General Health and Wellness
- Mental Health and Wellness
- Social Connectedness / Social Isolation
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Audience
- Academics
- Government (Politicians, Policy Makers) and Health Authorities
- Service Providers (Non-profits, Community Organizations, Local government)
- Health Authorities
- Caregivers, Seniors & Volunteers
- Government
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Category
- Research & Evidence
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