Association Between Neighborhood Disadvantage and Cognition in Older Adults with Focal Epilepsy
Abstract number :
1.345
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2023
Submission ID :
96
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Anny Reyes, PhD – University of California, San Diego
Divya Prabhakaran, B.S. – University of California, San Diego; Darwin Buckner, B.S – University of California, San Diego; Alena Stasenko, PhD – University of California, San Diego; Adam Schadler, MS – University of California, San Diego; Jerry Shih, MD – University of California, San Diego; Vicente Iragui-Madoz, MD-PhD – University of California, San Diego; Lisa Ferguson, MA – Cleveland Clinic; Jana Jones, PhD – University of Wisconsin School of Medicine and Public Health, Madison; Robyn Busch, PhD – Cleveland Clinic; Bruce Hermann, PhD – University of Wisconsin School of Medicine and Public Health, Madison; Carrie McDonald, PhD – University of California, San Diego
Rationale: Epilepsy is associated with significant health disparities, including disparities in the prevalence and incidence of epilepsy, access to care, and epilepsy outcomes. Several social determinants of health (SDOH) have been identified as contributing factors to these disparities, including economic deprivation, education and occupational attainment, discrimination and stigma, and sociocultural factors. The area deprivation index (ADI) is a proxy measure for assessing neighborhood-level socioeconomic disadvantage and it has been shown to be associated with multiple adverse health outcomes. In young-to-middle-aged patients with epilepsy, greater neighborhood disadvantage has been associated with worse cognition. Here, we examine the relationship between neighborhood disadvantage and cognitive, vascular, clinical, and sociodemographic profiles in older adults with epilepsy.
Methods: Thirty older adults (mean age= 66.9 years; mean education=15 years; 50% female; 78% non-hispanic white) completed cognitive testing including measures of learning and memory, language, processing speed, and practical judgment. A composite score was calculated for each cognitive domain by averaging across tests. Demographic, vascular, and sociodemographic information was obtained at a study visit. ADI deciles were calculated using the Neighborhood Atlas (UWSMPH) and classified as high (i.e., 6-10) or low (i.e., 1-5).
Results: Thirty-three percent of older adults with epilepsy had a high ADI (i.e., 6-10), suggesting significant socioeconomic disadvantage. Poorer performance on measures of learning (r=-.371, p=.043), memory (r=-.402, p=.028), and processing speed (r=-.383, p=.037) were associated with higher ADI (most disadvantaged); Figure 1. Those with higher ADI also demonstrated greater impairment in practical judgment (r= -.382, p=.041). Lower ADI (least disadvantaged) was associated with higher personal and family income (p< .001), and there was a trend towards greater years of education being associated with lower ADI (p=.088). There were no other differences in demographic, clinical, and vascular variables between patients with high and low ADI.
Behavior