Neighborhood deprivation and mortality among people with Alzheimer’s disease and related dementia

Abstract

Background: There are limited studies quantifying the extent to which neighborhood deprivation affects mortality in individuals living with Alzheimer’s disease (AD) and AD-related dementias (AD/ADRD). Objective: To quantify to what extent neighborhood deprivation affects adverse outcomes in individuals living with AD/ADRD. Methods: We identified individuals with AD/ADRD using a 15% random sample of national Medicare fee-for-service beneficiaries. Area deprivation index (ADI) was spatially linked to the Medicare AD/ADRD cohort using zip codes. Multivariate logistic regression was applied to examine the association between ADI and all-cause mortality among beneficiaries with AD/ADRD. Results: After adjusting for patients characteristics, compared to the lowest ADI quartile (Q1), higher ADI quartiles were associated with higher odds of all-cause mortality in individuals with AD/ADRD (Q2 = OR 1.08 [95% CI: 1.06, 1.10], Q3=OR 1.09 [95% CI: 1.07, 1.11], and Q4 OR 1.05 [95% CI: 1.03, 1.07]). Conclusions: Neighborhood deprivation is an independent risk factor for mortality in persons with AD/ADRD.