Neighborhood disadvantage and the risk of dementia and mortality among refugees to Denmark: A quasi-experimental study

Kim, Min Hee; Foverskov, Else; Frøslev, Trine; White, Justin S.; Glymour, M. Maria; Hainmueller, Jens; Pedersen, Lars Jacob Tynes; Sørensen, Henrik Toft; Hamad, Rita

doi:10.1016/j.ssmph.2022.101312

Cited by 5 publications

(8 citation statements)

References 59 publications

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“…These challenges can impact FDPs' physical and mental health and create additional exposure to other social and structural determinants of health that compound their health vulnerability, such as being exposed to hazardous working conditions, living in poorer neighborhoods, or difficulty accessing the health care system, which can lead to, exacerbate, or complicate care of existing neurologic illnesses. [29][30][31][32] Further, cognitive and behavioral deficits "acquired" in the premigration and migration journey phases may augment challenges with integration in the postmigra-tory phase, magnifying health disparities. For example, themes from a qualitative study of U.S.-based Vietnamese refugees found that refugees experienced a deep sense of isolation and loneliness with a limited support system in the United States, which was a result of family separation during the migration journey, and experiences of loss that many were continuing to process even decades after immigration.…”

Section: Postmigratory Phasementioning

confidence: 99%

“…33 As FDPs age in resettled countries and in refugee camps where they may live for decades and die, there is burgeoning attention to their dementia risk. 30,34,35 Dementia risk may heighten due to the cumulative migration journey trauma exposures. One systematic review examining data on 12 identifiable modifiable risk factors for dementia among refugees and asylum seekers in Australia, found that they had a higher prevalence of depression, social isolation, physical inactivity, and diabetes mellitus than their Australian-born counterparts.…”

Section: Postmigratory Phasementioning

confidence: 99%

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Neurological Care of Refugees and Other Forcibly Displaced Persons

Saadi,

Prabhu,

Snyder

et al. 2024

Semin Neurol

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There are more than 100 million forcibly displaced persons (FDPs) in the world today, including a high number of people who experience neurologic symptoms and presentations. This review summarizes the conceptual frameworks for understanding neurological health risks and conditions across the migration journey (premigration, migration journey, and postmigration) and life span, including special attention to pediatric FDPs. The interaction with psychiatric illness is discussed, as well as the available published data on neurologic presentations in FDPs in the medical literature. A social determinant of health lens is used to provide ways in which forcible displacement can influence brain health and neurological outcomes. Priorities and future needs for the neurological care of refugees and other FDPs are suggested.

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Section: Postmigratory Phasementioning

confidence: 99%

Section: Postmigratory Phasementioning

confidence: 99%

Neurological Care of Refugees and Other Forcibly Displaced Persons

Saadi,

Prabhu,

Snyder

et al. 2024

Semin Neurol

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“…In a cross-sectional sample of older Asian Americans and dementia cases in California, nativity was not shown to change incidence rates for dementia (Hayes-Larson et al , 2023 ). Similarly, a longitudinal study comparing native and foreign-born refugee residents aged 40 years and older in Denmark did not find a relationship between neighbourhood disadvantage and dementia risk (Kim et al , 2022 ).…”

Section: Introductionmentioning

confidence: 98%

Disparities in neighbourhood characteristics and 10-year dementia risk by nativity status

Wong,

Soong

2024

Epidemiol Psychiatr Sci

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Aims Prior research indicates that neighbourhood disadvantage increases dementia risk. There is, however, inconclusive evidence on the relationship between nativity and cognitive impairment. To our knowledge, our study is the first to analyse how nativity and neighbourhood interact to influence dementia risk. Methods Ten years of prospective cohort data (2011–2020) were retrieved from the National Health and Aging Trends Study, a nationally representative sample of 5,362 U.S. older adults aged 65+. Cox regression analysed time to dementia diagnosis using nativity status (foreign- or native-born) and composite scores for neighbourhood physical disorder (litter, graffiti and vacancies) and social cohesion (know, help and trust each other), after applying sampling weights and imputing missing data. Results In a weighted sample representing 26.9 million older adults, about 9.5% (n = 2.5 million) identified as foreign-born and 24.4% (n = 6.5 million) had an incident dementia diagnosis. Average baseline neighbourhood physical disorder was 0.19 (range 0–9), and baseline social cohesion was 4.28 (range 0–6). Baseline neighbourhood physical disorder was significantly higher among foreign-born (mean = 0.28) compared to native-born (mean = 0.18) older adults (t = −2.4, p = .02). Baseline neighbourhood social cohesion was significantly lower for foreign-born (mean = 3.57) compared to native-born (mean = 4.33) older adults (t = 5.5, p < .001). After adjusting for sociodemographic, health and neighbourhood variables, foreign-born older adults had a 51% significantly higher dementia risk (adjusted hazard ratio = 1.51, 95% CI = 1.19–1.90, p < .01). There were no significant interactions for nativity with neighbourhood physical disorder or social cohesion. Conclusions Our findings suggest that foreign-born older adults have higher neighbourhood physical disorder and lower social cohesion compared to native-born older adults. Despite the higher dementia risk, we observed for foreign-born older adults, and this relationship was not moderated by either neighbourhood physical disorder or social cohesion. Further research is needed to understand what factors are contributing to elevated dementia risk among foreign-born older adults.

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“…For example, net of individual characteristics, cohort and brain‐bank studies in the United States and United Kingdom have identified a greater risk among individuals living in the most socioeconomically disadvantaged neighborhoods relative to the least of: cognitive deficits, white matter damage, mild cognitive impairment, dementia, progression to dementia from non‐impairment, and Alzheimer disease–associated neuropathology 7–13 . Similar investigations in Denmark and France have reported null findings 14,15 . Supplementary Table S1 provides full details on the extant empirical literature on neighborhood characteristics and dementia/dementia antecedents.…”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 , 9 , 10 , 11 , 12 , 13 Similar investigations in Denmark and France have reported null findings. 14 , 15 Supplementary Table S1 provides full details on the extant empirical literature on neighborhood characteristics and dementia/dementia antecedents.…”

Section: Introductionmentioning

confidence: 99%

Dementia, dementia's risk factors and premorbid brain structure are concentrated in disadvantaged areas: National register and birth‐cohort geographic analyses

Reuben,

Richmond‐Rakerd,

Milne

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONDementia risk may be elevated in socioeconomically disadvantaged neighborhoods. Reasons for this remain unclear, and this elevation has yet to be shown at a national population level.METHODSWe tested whether dementia was more prevalent in disadvantaged neighborhoods across the New Zealand population (N = 1.41 million analytic sample) over a 20‐year observation. We then tested whether premorbid dementia risk factors and MRI‐measured brain‐structure antecedents were more prevalent among midlife residents of disadvantaged neighborhoods in a population‐representative NZ‐birth‐cohort (N = 938 analytic sample).RESULTSPeople residing in disadvantaged neighborhoods were at greater risk of dementia (HR per‐quintile‐disadvantage‐increase = 1.09, 95% confidence interval [CI]:1.08‐1.10) and, decades before clinical endpoints typically emerge, evidenced elevated dementia‐risk scores (CAIDE, LIBRA, Lancet, ANU‐ADRI, DunedinARB; β’s 0.31‐0.39) and displayed dementia‐associated brain structural deficits and cognitive difficulties/decline.DISCUSSIONDisadvantaged neighborhoods have more residents with dementia, and decades before dementia is diagnosed, residents have more dementia‐risk factors and brain‐structure antecedents. Whether or not neighborhoods causally influence risk, they may offer scalable opportunities for primary dementia prevention.

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Neighborhood disadvantage and the risk of dementia and mortality among refugees to Denmark: A quasi-experimental study

Cited by 5 publications

References 59 publications

Neurological Care of Refugees and Other Forcibly Displaced Persons

Neurological Care of Refugees and Other Forcibly Displaced Persons

Disparities in neighbourhood characteristics and 10-year dementia risk by nativity status

Dementia, dementia's risk factors and premorbid brain structure are concentrated in disadvantaged areas: National register and birth‐cohort geographic analyses

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