Neighbourhood Socioeconomic Deprivation and Older Adults' Cognitive Decline in Porto, Portugal: A 13-Year (2005-2018) Longitudinal Analysis Using the Population-Based EPIPorto Cohort

Abstract

Objectives Living in socioeconomically deprived areas has been linked to poorer health outcomes, with older adults potentially more vulnerable due to cumulative environmental exposure. This study examined the association between neighbourhood socioeconomic deprivation and cognitive decline among older adults in Porto, Portugal.Methods We used data from 486 participants aged >= 50 years in the EPIPorto cohort, each with at least two cognitive assessments between 2005 and 2018. Neighbourhood deprivation was measured using the Portuguese European Deprivation Index; cognitive function was assessed with the Mini-Mental State Examination. Missing data were addressed using multivariate imputation (mice package), and associations were estimated via linear mixed-effects models (lme4 package).Results The average cognitive decline was -0.60 points between assessments (95% CI: -0.82 to -0.37). In unadjusted models, higher neighbourhood deprivation was associated with faster decline (beta = -0.18; 95% CI: -0.29 to -0.06), but this was not significant after adjustment (beta = 0.00; 95% CI: -0.11-0.12). Greater decline was significantly associated with older age, female sex, and lower education.Conclusion Findings highlight the role of individual sociodemographic factors but indicate no significant association with neighbourhood deprivation.