Cambridge researchers have revealed new evidence explaining why living in a socioeconomically disadvantaged neighbourhood may raise a person’s likelihood of developing dementia. Their study suggests that the environment in which someone lives can influence both the condition of the brain’s small blood vessels and the ability to maintain lifestyle habits that protect cognitive health. Rather than dementia risk being shaped only by personal choices or genetics, this research strengthens the argument that broader social conditions play a major role in long-term brain health. The findings, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, provide further clarity on how midlife deprivation can set the stage for cognitive decline decades later.
Dementia has long been observed to affect people in disadvantaged communities more frequently and at earlier stages. Importantly, this increased risk appears even among individuals who are financially stable or well educated themselves, suggesting that the characteristics of the neighbourhood environment shape health outcomes beyond individual circumstances. Earlier research has also found that people in deprived areas tend to show more signs of structural brain damage, including stress to brain tissue, though the underlying reasons have not been well understood. This new study offers evidence that these effects may be linked to the health of small blood vessels in the brain, which are essential for carrying oxygen and nutrients to the neural systems involved in memory, attention, and decision-making.
The Cambridge team examined data from 585 adults aged 40 to 59 living across the UK and Ireland, who were participating in the PREVENT-Dementia programme, which follows people in midlife to identify early risk factors. Participants were assessed on several measures: the level of neighbourhood deprivation based on their postcode; their performance on cognitive tests; lifestyle risk factors such as sleep quality, physical activity, weight, and blood pressure; and MRI scans to detect any early signs of damage in the brain’s small vessels. By comparing these factors, the researchers were able to explore how environmental disadvantage may influence brain health both directly and indirectly.
The study showed that individuals living in areas with higher unemployment rates, lower incomes, or fewer educational opportunities were more likely to experience difficulties maintaining healthy lifestyle habits. They were more likely to have poor sleep, higher blood pressure, obesity, and lower physical activity levels. All of these are known contributors to dementia risk because they can damage the brain’s vascular system over time. Interestingly, people in more deprived communities tended to drink less alcohol than those in more affluent neighbourhoods, reminding us that health patterns vary across contexts and that public health strategies must be tailored accordingly.
Neighbourhood deprivation was also associated with reduced cognitive performance, particularly in processing speed, spatial awareness, and concentration. These skills are vital for everyday functioning and often decline early in the path toward dementia. The researchers believe this reduced cognitive ability may be tied to the vascular damage seen on brain scans. When small vessels are weakened or obstructed, the brain receives less oxygen and fewer nutrients, which can gradually impair neural function. Crucially, the findings showed that these effects were not simply a matter of individual education levels or personal background. Even people with university degrees and stable employment were affected when they lived in deprived areas, highlighting how the physical and social environment can shape behaviour and health in powerful ways.
The results of this study emphasise that dementia prevention must go beyond encouraging individuals to make healthier lifestyle choices. While personal habits are essential, people can only act within the possibilities their environment allows. If someone lives in a neighbourhood without safe public spaces, access to affordable, healthy food, reliable healthcare, or a sense of security, maintaining good health becomes far more difficult. The researchers argue that meaningful dementia prevention will require policymakers to address the social conditions that limit healthy living. Improving neighbourhood safety, creating accessible exercise spaces, reducing economic inequality, and strengthening community support systems could all help lower dementia risk at a population level. In short, the study reinforces the idea that where we live deeply matters for how our brains age.
More information: Audrey Low et al, Neighborhood deprivation and midlife cognition: Evidence of a modifiable vascular pathway involving health behaviors and cerebral small vessel disease, Alzheimer’s & Dementia. DOI: 10.1002/alz.70756
Journal information: Alzheimer’s & Dementia Provided by University of Cambridge
