The Social Determinants of Health: Disparities in Cognitive Aging and Dementia

Cognitive health during aging is influenced by social determinants of health (SDOH)—the conditions in which we are born, work, live, learn, and age and the forces and policies that influence those conditions. Because of differences in social environments and access to resources, not all individuals experience healthy cognitive aging. This review highlights SDOH and reviews the evidence for their impact on cognitive aging and risk of dementia among older adults. We start by defining the key constructs of SDOH and briefly review disparities in cognitive aging and dementia. We then review mechanisms linking SDOH to cognitive aging and dementia, discuss seminal topics that laid the groundwork for the study of SDOH today, and review new areas of research on neighborhood disadvantage, green space, environmental contaminants, and stressful living conditions. With the rapidly growing population of older adults, understanding the social drivers of cognitive health has important implications for brain aging and dementia prevention.