Social Determinants of Health in Community-Dwelling Dementia Patients Aged 65 and Over: Analysis of the 2019 National Health Interview Survey

Joanne M. Li*, Malaz A. Boustani, Dustin D. French

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Alzheimer’s Disease and related dementias affect 3.4 million community-dwelling adults in the United States. Given the burden of disease, a greater understanding of modifiable risk factors is crucial for targeted public health strategies. Social determinants of health (SDOH) are modifiable risk factors categorized in five domains: economic status, education, healthcare access, environment, and community context. Although individual SDOH have been linked to dementia, limited research exists on the interaction of SDOH with dementia across multiple domains. The aim of this study was to evaluate the association between SDOH across all five domains and dementia among community-dwelling adults in the United States. A cross-sectional study was performed on community-dwelling adults aged ≥65 years from the 2019 National Health Interview Survey (NHIS). Respondents (N = 9,277), of whom 303 (4%) self-reported positive dementia diagnosis, were predominantly female (55%), white (76%), and non-Hispanic (91%). Residing in a non-metropolitan area, having a usual place for healthcare, and receiving annual eye or dental exams were negatively associated with dementia. Minority compared to white status was not significantly associated with dementia, suggesting underdiagnosis of dementia within minority groups in the NHIS. We present the first comprehensive national view of SDOH among community-dwelling dementia patients in the United States.

Original languageEnglish (US)
JournalGerontology and Geriatric Medicine
Volume9
DOIs
StatePublished - Jan 1 2023

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study resulting in this publication was assisted by a grant from the Baker Program in Undergraduate Research, which is administered by Northwestern University’s Weinberg College of Arts and Sciences (1516WCASSUM2222145). However, the conclusions, opinions, and other statements in this publication are the authors’ and not necessarily those of the sponsoring institution.

Keywords

  • Medicare
  • dementia
  • health care disparity
  • population health
  • social determinants of health

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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