# The Neighborhoods Study: Contextual Disadvantage and Alzheimer’s Disease and Related Dementias (ADRD)

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2021 · $4,760,115

## Abstract

Dementia due to Alzheimer’s disease and related dementias (ADRD) disproportionately impacts racial/ethnic
minorities and the socioeconomically disadvantaged. Development of effective interventions require mechanistic
understanding of distal fundamental forces, including socioeconomic context (i.e. “neighborhood disadvantage”
or the social determinants of health of a given area), that put people at “risk for [more proximal] risks” such as
individual-level income, education, health behaviors and comorbidity. Prior research supports that contextual
disadvantage is modifiable and interacts with biological processes to produce disease, yet little is known of its
impact on ADRD. Towards this, we created validated quantifications of neighborhood disadvantage for the full
US. This Area Deprivation Index (ADI) incorporates poverty, education, housing and employment indicators;
predicts disparity-related health outcomes; and is freely shared through our public platform (the Neighborhood
Atlas). We have validated survey and public data-based residential history tracing methodologies that establish
dosage and timing of neighborhood disadvantage exposure across a life-course for both living and deceased
persons. We have demonstrated that even after adjustment for individual risk factors, neighborhood
disadvantage is strongly associated with cognitive function, neurodegeneration shown on MRI, and post-mortem
AD plaque neuropathology. However, our current sample is lacking in geographic diversity and is of insufficient
size to conduct a more robust multi-factor phenotypic risk assessment of social-biological interactions and their
mechanisms; a necessary foundation towards developing new therapeutic intervention. This proposal employs
collaboration with 22 Alzheimer’s Disease Research Centers (ADRC) and their existing cognitive, neuroimaging
and neuropathology data. We take on the substantial work to create detailed residential histories for each ADRC
subject (N~9,234 living, N~10,469 brain bank) to establish a dosage and timing of neighborhood disadvantage
exposure across each life-course. Hypothesis: Larger and earlier exposures to neighborhood disadvantage will
predict lower cognitive function, faster cognitive decline and greater disease burden including AD neuropathology
among the targeted sample. Aim 1: Determine the impact of the cumulative dose and timing of neighborhood
disadvantage exposure (indexed by ADI), on cognitive function and change over time; Aim 2: on AD-specific
markers indexed by neuroimaging (amyloid and tau PET) and the secondary outcome of volumetric MRI; and
Aim 3: on neuropathologic tissue features and diagnosis. Aim 4: Using existing ADRC data and newly collected
survey data, define the extent to which individual race/ethnicity, age, sex, income, education, comorbidity and
health-behaviors mediate these relationships. The proposed project, if funded, will be the largest study of its kind
on social determinants of health in the contex...

## Key facts

- **NIH application ID:** 10125734
- **Project number:** 1R01AG070883-01
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Barbara Brigitta Bendlin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $4,760,115
- **Award type:** 1
- **Project period:** 2021-03-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10125734

## Citation

> US National Institutes of Health, RePORTER application 10125734, The Neighborhoods Study: Contextual Disadvantage and Alzheimer’s Disease and Related Dementias (ADRD) (1R01AG070883-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10125734. Licensed CC0.

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