Research published in the journal Neurology reveals that individuals with lower incomes and those from historically underrepresented racial and ethnic groups are more likely to have modifiable risk factors associated with dementia. The study, led by Eric L. Stulberg, MD, MPH, of the Thomas Jefferson University Sidney Kimmel Medical College, sheds light on the disparities affecting these populations.
The study assessed over 5,000 participants for 13 dementia risk factors, including low education, alcohol use, obesity, high LDL cholesterol, and social isolation, among others. The findings indicate that while there are correlations between income, race, and increased risk for dementia, the research does not establish direct causation. Stulberg emphasized the importance of understanding these associations, stating, “Our findings provide new insight into how people living below the poverty line and those from historically under-resourced groups may bear a higher burden of many modifiable dementia risk factors.”
Key Findings on Income and Dementia Risk
Participants were categorized into six income groups, with those in the lowest group earning below the federal poverty level. The results showed that higher income levels corresponded to a lower prevalence of dementia risk factors, with the exception of obesity, high cholesterol, and traumatic brain injury. Specifically, individuals in higher income categories were 9% less likely to possess additional risk factors as income increased.
Among those in the lowest income group, vision loss and social isolation were notably prevalent. Researchers estimated that addressing vision loss could potentially mitigate 21% of dementia cases, while reducing social isolation might impact 20% of cases. Stulberg remarked on the implications of these findings, suggesting that enhancing access to vision care and promoting social connections could significantly benefit older adults in poverty.
Impact on Historically Underrepresented Groups
The analysis also revealed that several risk factors, including diabetes and physical inactivity, were more pronounced in historically underrepresented groups in clinical studies, such as Black Americans and Hispanic Americans, compared to their white counterparts. Stulberg highlighted the potential for targeted interventions: “Our results suggest there may be an opportunity to help people reduce their dementia risk factors now, thereby reducing risks among people with lower incomes and historically underrepresented populations.”
While the study provides valuable insights, it is important to note its limitations. The research offers only a snapshot in time without following participants over extended periods. Additionally, some data were self-reported, raising questions about accuracy. Stulberg expressed hope for future studies to evaluate the impact of addressing these late-life risk factors, particularly for those living below the poverty line.
As dementia continues to pose a significant challenge globally, understanding the interplay between socioeconomic status, race, and modifiable risk factors is crucial for developing effective prevention strategies. The findings from this research could pave the way for policies aimed at improving health outcomes for underserved populations.
More information can be found in the study by Stulberg et al., “Income, Race-Ethnicity, and Dementia Risk Factors in the United States,” published in Neurology in 2025.
