Poor neighbourhoods linked to memory decline in women

Women in high-poverty areas saw memory decline of 7 per cent per decade in midlife, with even sharper drops of 10 per cent among Black women.

The study tracked 1,391 women in the US for up to 13.5 years and found that exposure to concentrated neighbourhood poverty was associated with sharper decline in episodic memory – the ability to recall specific personal experiences or information.

Unlike processing speed, which tends to decline naturally with age, episodic memory typically remains stable through midlife. A faster-than-expected drop may signal increased risk of later cognitive problems, including dementia.

The Study of Women’s Health Across the Nation (SWAN) followed participants aged 49 to 60 from Ann Arbor, Boston, Chicago, Alameda and Contra Costa counties in California, Los Angeles, Jersey City and Pittsburgh. Researchers from Albert Einstein College of Medicine repeatedly tested their cognitive abilities while tracking residential history and neighbourhood conditions.

To assess concentrated poverty, researchers used US Census data to evaluate poverty levels in each participant’s census tract and surrounding tracts, classifying neighbourhoods as low, moderate or high poverty.

High-concentration areas were defined as those with unusually high poverty rates that were geographically clustered. These measures also accounted for participants who had moved and changing neighbourhood conditions over time.

Study author Jinshil Hyun is assistant professor in the Saul R. Korey Department of Neurology at Albert Einstein College of Medicine.

The researcher said: “Research has shown that people living in low-income neighbourhoods are more likely to develop various physical and mental illnesses and tend to have shorter lifespans than people living in higher-income areas.

“However, people’s neighbourhood exposures are not restricted to the immediate areas around their homes, as they tend to actively seek resources, such as food, from nearby neighbourhoods to meet their daily needs.

“We hypothesised that individuals living in low-income neighbourhoods might successfully access better resources elsewhere, unless their communities are surrounded entirely by other low-income neighbourhoods.

“In such cases, their access would be severely restricted, potentially harming their health-related behaviours and health outcomes.”

Women in high-concentration poverty areas experienced faster decline in both immediate and delayed episodic memory.

Those in lower-poverty neighbourhoods showed either no decline or only mild reductions. The pattern held even after accounting for menopause status, physical activity, education, smoking and alcohol use.

Processing speed and working memory showed different trends.

Women in poorer areas had lower baseline scores but did not decline faster than women in wealthier areas, suggesting poverty may affect early brain health more than the pace of age-related change.

The steepest decline in delayed memory was found among Black women living in high-poverty areas. Researchers said this may reflect the cumulative impact of systemic inequalities such as racial discrimination and economic segregation.

Hyun told PsyPost: “Experiencing cognitive decline is a natural part of ageing, and different aspects of cognition decline at different rates.

“For example, processing speed typically starts to slow down in early adulthood, while memory usually remains stable until later in life.

“However, our study revealed that women living in areas of concentrated poverty experienced accelerated memory decline even during midlife (approximately 7 per cent per decade).

“Those living in higher income areas did not show significant memory decline.

“This suggests that living in highly concentrated low-income neighbourhoods may be related to increased rates of cognitive ageing, potentially increasing the risk of Alzheimer’s disease and related dementias.”

Cardiovascular health and physical activity – both known to affect cognition – did not fully explain the observed disparities.

Other factors, including chronic stress, pollution, or limited access to enriching environments, may also play a role.

“I was not surprised that living in high-poverty neighbourhoods was associated with faster cognitive decline, but the magnitude of this effect was unexpectedly large,” Hyun said.

“While residents of affluent neighbourhoods showed no significant memory decline, residents of areas with concentrated poverty experienced a 7 per cent decline per decade.

“Greater memory decline in midlife could serve as an early indicator of future Alzheimer’s risk. Alzheimer’s disease currently has no cure, and effective treatment options are limited.

“Therefore, addressing neighbourhood and individual risk factors of Alzheimer’s disease as early as in midlife would be crucial.”

The researchers noted some limitations, including the urban sample, which may not apply to women in rural areas.

They also did not assess childhood neighbourhood exposure or participants’ daily routines outside the home, such as workplaces, which could also influence cognitive health.