Dementia Risk May Be Associated With Income Level

A higher prevalence of risk factors for dementia is associated with lower income, according to a recent study.¹ Modifiable risk factors related to dementia like high blood pressure, depression, physical inactivity, and hearing loss were more common in lower income and historically underrepresented racial and ethnic groups.

The study included over 5000 individuals, who were assessed for 13 different dementia risk factors. Risk factors included were low education, obesity, alcohol use, high LDL cholesterol, untreated hearing loss, traumatic brain injury, vision loss, untreated high blood pressure, diabetes, smoking, depression, physical inactivity, and social isolation. Data analysis also took into account age, sex, race, and ethnicity. Study authors noted that race and ethnicity, while included in analysis, are socially based constructs and not biological variables. Participants were divided into 6 income groups, from the lowest income group below the federal poverty level to the highest income group at more than 5 times the federal poverty level. For each different income group, investigators determined the percentage of individuals who had each risk factor, along with the percentage of dementia cases that could theoretically be prevented or delayed if those risk factors were eliminated.

“Our results suggest there may be an opportunity to help people reduce their dementia risk factors now, thereby reducing risks among people with lower incomes and historically underrepresented populations in clinical studies, where our study suggests many risk factors are more prevalent,” study author Eric L. Stulberg, MD, MPH, of the Thomas Jefferson University Sidney Kimmel Medical College, said in a press release. Dr Stulberg added that, “It is exciting to see that even late-life risk factors may be targets for interventions. We hope that future studies evaluate if targeting these late-life risk factors may yield benefits, particularly for people who are living below the poverty level.”

Investigators found that higher incomes were associated with lower prevalence of nearly every dementia risk factor analyzed.⁴ Obesity, high cholesterol, and traumatic brain injury were the factors not found to be lower in the high income groups. Each ascending income group had 100% income increase above the federal poverty level, and each increasing group was 9% less likely to have an additional risk factor at middle age. In the lowest income group (below the poverty level), vision loss and social isolation were notably present risk factors. In this group, investigators calculated that 21% of dementia cases could be mitigated by addressing vision loss, and 20% could be mitigated by addressing social isolation—showing 1 in 5 cases may be associated with vision loss or social isolation in older individuals. Adjusting for income, some risk factors still showed stronger associations for groups historically underrepresented in clinical studies. Black Americans, Mexican Americans, and non-Mexican Hispanic Americans showed higher association for risk factors of diabetes, physical inactivity, obesity, and vision loss, compared with White Americans.

Stulberg pointed out that, “while our results are exploratory and do not show cause and effect, improving access to vision care and reducing social isolation among older adults could potentially have a major impact in those living below the poverty level.”

Authors also noted a limitation of the study that it was not longitudinal, and some information was self-reported by participants, which does not guarantee accurate reporting. These findings are consistent with previous studies examining income or socioeconomic status and dementia risk or prevalence.^2,3

References

1. New study reveals how your income may shape your risk of dementia. Press release. November 12, 2025. Accessed November 12, 2025. https://www.aan.com/PressRoom/Home/PressRelease/5295

2. Ou YN, Zhang YB, Li YZ, et al. Socioeconomic status, lifestyle and risk of incident dementia: a prospective cohort study of 276730 participants. Geroscience. 2024;46(2):2265-2279.

3. Heger I, van Boxtel M, Deckers K, et al. Socioeconomic position, modifiable dementia risk and cognitive decline: results of 12-year Maastricht Aging Study. Intl Psychoger. 2025;36(7):574-586.

4. Stulberg EL, Wu C, Law CA, et al. Income, race-ethnicity, and dementia risk factors in the United States. Neurology. 2025;105(11):e214402.