Observational analysis finds links between cognitive function and social isolation in Black adults, suggesting a need for targeted health interventions.
Purpose: Black adults and people with low socioeconomic status experience higher rates of cognitive impairment than White adults. Social isolation, emotional distress, and poor quality of life (QOL) co-occur with cognitive decline in older adults, yet few studies have explored these factors in Black adults living in persistent poverty areas who are physically inactive and at greater risk of cognitive impairment and cancer. The purpose of this study was to explore the associations between cognitive function, social isolation, and QOL in midlife and older Black adults living in Acres Homes, an urban persistent poverty community. Method: The Partnering to Prevent Cancer and Alzheimer’s Disease (PPCAD) study sought to explore behavioral and non-medical determinants of cancer and Alzheimer’s Disease and related dementia (ADRD) risk.. Black adults who were ≥45 years, have overweight or obesity (body mass index [BMI] ≥25.0 kg/m2), and were sedentary (self-report sitting ≥6 hours/day) were recruited to PPCAD and completed an in-person assessment between Feb 2024-Apr 2025. Participants completed the Mini-cog to assess cognitive impairment and questionnaires to assess subjective cognitive decline (SCD), social isolation, and physical and mental health-related QOL. Independent samples t-tests were used to explore differences in PROMIS-measured social isolation, physical health, and mental health T-scores by cognitive impairment status and SCD. Results: Participants (N=50) were mostly women (78.0%) in their 60s (M age=66.6±9.0 years) and were overweight on average (M BMI=29.9±12.2 kg/m2). Less than half (40.0%) completed college, and 34% reported a household income below the federal poverty level. Cognitive impairment assessed via the Mini-cog was 20.0% (M score=3.6±1.2), and 19.1% self-reported subjective cognitive decline. There was a statistically significant difference in social isolation between those who were cognitively impaired (M T-score=49.9±7.9) and those who had no impairment (M T-score=44.6±1.1, t=-2.2, p=.037), and the difference was similar between those reporting SCD (M T=score=50.4±5.4) and those without SCD (M T-score=44.4±7.4, t=-2.2, p=.030). Those with SCD also reported statistically significantly worse physical (M T-score=33.4±6.9) and mental (M T-score=35.7±6.5) health than those without SCD (M physical T-score=38.5±5.5, t=2.3, p=.028; M mental T-score=41.8±6.4, t=2.4,p=.021). Conclusions: Midlife and older Black adults in this study who were cognitively impaired and reported SCD, consistently reported greater social isolation, and those reporting SCD also reported poorer physical and mental health. Findings point to the need for interventions that foster social connectedness to combat loneliness and seek to improve QOL through movement and psychoeducation. Future research is needed to further identify and address non-medical drivers of health through tailored approaches to reduce cancer and ADRD risk and improve health outcomes in this vulnerable population. Citation Format: Scherezade K. Mama, Xavier Brown, Lisa M. Lowenstein, Karen Basen-Engquist, Ruth Rechis, Lorna H. McNeill. Poor cognitive function and social isolation contribute to cancer and Alzheimer’s Disease risk in midlife and older Black adults living in a persistent poverty community [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A011.
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