Where patients live may matter for brain aging

Clinical takeaway: Consider neighborhood context when evaluating brain health, particularly when vascular or cognitive risk is already a concern. Patients in highly disadvantaged areas may benefit from closer attention to modifiable vascular risks and barriers to preventive care.

Brain health counseling typically centers on individual behaviors and medical conditions, but patients’ surroundings may also matter. A study of routine clinical MRI scans found that neighborhood disadvantage was associated with older-appearing brains, lower brain volume, and more signs of vascular injury.

Researchers analyzed brain MRIs from 2,826 patients aged 18 to 96 years whose scans showed no evidence of disease. Neighborhood disadvantage was measured using the Area Deprivation Index, which incorporates local income, education, employment, and housing conditions.

In adjusted analyses, the brains of patients living in the most disadvantaged neighborhoods appeared about 2.1 to 2.4 years older than those of patients in less disadvantaged areas. An older-appearing brain has been linked to cardiovascular risk factors, cognitive impairment, and psychiatric illness.

The most disadvantaged group also had lower total brain volume and more white matter hyperintensities, bright spots on MRI that often reflect damage to small blood vessels in the brain.

The cross-sectional study cannot establish that neighborhood conditions caused the MRI differences, and a neighborhood-level measure cannot replace individual assessment. However, the findings support considering social context when evaluating brain health. Asking about access to healthy food, medications, safe physical activity, adequate sleep, and follow-up care may help clinicians identify barriers that make vascular risk more difficult to control.

“The conditions in which individuals are born, live, work and age, profoundly shape long-term neurological health outcomes,” said study author John-Paul J. Yu, MD, PhD, associate professor at the University of Wisconsin School of Medicine and Public Health.

Source: Willbrand EH, et al. (2026 Sep 15) Radiology. Evaluating the effect of neighborhood-level disadvantage on brain health: an imaging epidemiology study