Older people living in deprived areas face increased risk of developing dementia

People who live in disadvantaged areas have a greater risk of developing cognitive impairment (an early risk factor for dementia) according to research involving teams from Trinity College Dublin, Ulster University, Maynooth University, and clinicians from health services, North and South.

The findings of their study, just published in the Journal of the American Geriatric Association, are based on novel analysis of data collected for the TUDA Ageing study of over 5,000 older people across the Island of Ireland, which uses geo-referenced, address-based techniques to map and link participants to official socioeconomic indicators of deprivation for Northern Ireland and the Republic of Ireland.

Compared with people in the least deprived areas, those living in the most deprived areas had: spent three years less in formal education; higher rates of smoking and higher alcohol consumption; higher rates of obesity; higher blood pressure; and a higher risk of diabetes. Older people living in deprived areas across the island of Ireland were also more likely to suffer from depression and anxiety.

Even after all these factors were taken into consideration in the analysis of the study results, older people living in the most deprived areas were found to be at a 40% higher risk of having cognitive impairment compared with people of the same age living in the least deprived areas. This suggests that factors relating to the living environment, such as income inequality and access to resources, may be implicated.

Professor Conal Cunningham, Consultant Geriatrician from St James Hospital Dublin, and a co-author of the paper, said: “The results show that living in a disadvantaged area significantly predicts worse cognitive health in older age. These are important findings and we must give priority to tackling the inequalities that this report highlights in mental health in older age.”

The researchers hope the findings may shape international policy to improve health outcomes in older adults, specifically in the area of preventing dementia. The findings identify the potential for effective dementia prevention through targeted interventions that modify risk factors in communities with the greatest area-level socioeconomic deprivation.

Professor Adrian Moore, Head of the School of Geography and Environmental Sciences, Ulster University, is the senior author of the paper. He said: “This is the first study of its kind to use this particular geo-referencing methodology in a cross-jurisdictional manner to integrate data from these nationally independent datasets, thus enabling the TUDA study cohort as a whole to be examined in terms of the underlying socioeconomic profile of the base populations. This provided a unique opportunity to link area-level deprivation with cognitive performance among older adults from two separate health systems.”

Funding for the original Trinity, Ulster and Department of Agriculture (TUDA) study was provided by the Food for Health Research Initiative of the Irish Department of Agriculture and Health Research Board, with co-funding from the Department for Employment and Learning Northern Ireland under its Cross-Border Research and Development Programme: “Strengthening the all-Island Research Base”. The research was also supported via a small grant from the Centre for Ageing Research and Development in Ireland.