PROJECT SUMMARY An estimated 6.7 million Americans are living with Alzheimer’s disease (AD) dementia in 2023, with more than 55 million people living with AD worldwide. However, stark disparities exist in the prevalence of AD with older adults with multidimensional poverty being more than twice as likely to develop dementia during their lifetime. Resources, opportunities, and the environment where you live, work, play, and age, also known as the social determinants of health, have been proposed as significant predictors of numerous risk factors associated with dementia. This proposal will investigate the influence of a novel social determinant of health, neighborhood disadvantage, on (1) cardiovascular and metabolic risk factors, brain imaging biomarkers, and (2) cognitive function associated with AD and related dementias (ADRD). This project will utilize data from the Wake Forest Alzheimer’s Disease Research Center (ADRC) Clinical Core Cohort to conduct analyses investigating these relationships. Training will take place at the Wake Forest University School of Medicine in the Molecular Medicine and Translational Science (MMTS) and Medical programs as a part of the M.D./Ph.D. dual-degree program. The applicant will receive training in the foundational knowledge necessary to conduct health disparities research, statistical methodology and analytical design, and scientific writing and communication to accomplish the proposed aims. Mentorship for the proposal includes a multidisciplinary team with individuals in the ADRC, along with faculty in the Internal Medicine and Neurology departments. This team will provide the applicant with feedback every step along the way, regarding data analysis, interpretation of findings, and manuscript preparation. The proposed aims have the potential to provide new insights into the effects of one’s neighborhood-level disadvantage on various factors of risk associated with ADRD and further elucidate the influence of social determinants of health on risk for dementia.