Abstract
Black Americans a have higher risk of cognitive impairment relative to other racial/ethnic groups, and Black women have the highest prevalence of Alzheimer's disease and related dementias; however, the mechanisms underlying cognitive impairment are poorly understood. Neighborhood-level exposures that adversely influence cognitive aging may be distinct for Black women given historical and contemporary structural racism and sexism and their influence on neighborhood environments, which, in turn, adversely affect the cognitive health of Black women. This study examined the cross-sectional association between the Area Deprivation Index (ADI) and subjective cognitive function among 20,768 Black Women's Health Study cohort participants (M-age = 64.6, SD = 7.22). Multinomial logistic regression was used to calculate odds ratios and 95% confidence intervals for moderate (1-2 concerns) and poor (>= 3 concerns) versus good (0 concerns) subjective cognitive function associated with quintiles of ADI ascertained in 2015. In the unadjusted model, greater neighborhood disadvantage was associated with subjective cognitive impairment. However, this association was fully attenuated after adjusting for education. Results suggest neighborhood-level disadvantage, as measured by the ADI, is not associated with increased cognitive concerns after accounting for education among Black women. Although the ADI is well-established as a correlate of many health outcomes, primarily in White individuals, it has rarely been used in samples of exclusively Black individuals. Different measures of the neighborhood environment may be more pertinent for differentiating risk among Black women or for predicting subjective cognitive function.