WINSTON-SALEM, N.C., Oct. 15, 2025 — The conditions where you live may influence your brain health and risk for dementia, according to a new study from Wake Forest University School of Medicine
The study, published today in Alzheimer's & Dementia: Behavior & Socioeconomics of Aging, a journal of the Alzheimer's Association, found that individuals living in neighborhoods with higher levels of social vulnerability, environmental injustice and socioeconomic disadvantage showed measurable differences in brain structure and function.
"This study is consistent with other research showing that the state of the social environment in which people live can shape their brain health in profound ways," said Timothy Hughes, Ph.D., associate professor of gerontology and geriatric medicine at Wake Forest University School of Medicine and senior author.
Researchers analyzed data from 679 adults enrolled in the Healthy Brain Study at the Wake Forest Alzheimer's Disease Research Center. Each participant underwent brain scans and blood tests to detect early signs of Alzheimer's disease and related dementias. The team then compared these results with three national-level tools that assess neighborhood conditions at the level of the zip code: the Area Deprivation Index, Social Vulnerability Index and Environmental Justice Index.
Higher scores on these indices, reflecting greater neighborhood burden of the social determinants of health, were linked to changes in dementia-related biomarkers, especially among Black participants whose neighborhoods experienced the most burden of the social determinants. These dementia-related biomarkers included a thinner outer layer of the brain, white matter changes representing vascular disease, reduced blood flow and more uneven circulation, all of which may contribute to memory and cognitive decline over time.
"This study is one of the first to connect a variety of place-based social factors with advanced biological markers of dementia," said Sudarshan Krishnamurthy, a sixth-year M.D.-Ph.D. candidate and lead author. "It shows that the conditions and environment in which people live — such as access to clean air, safe housing, nutritious food and economic opportunity — may leave a lasting imprint on brain health."
The study contributes to a growing body of evidence that social and environmental factors are not just background influences but central to understanding and addressing Alzheimer's disease and related dementias.
Krishnamurthy emphasized the policy relevance of the findings.
"If we truly want to improve brain health across all communities, we must look beyond individual choices and hone in on the broader systems and structures that shape health at the neighborhood level."
This research was supported by the National Institutes of Health grants F30 AG085932 and P30 AG07294; and the American Heart Association grant 24PRE1200264.
