Frontiers in Neurology · Oct 13, 2026

Social support and cognition in a racially and ethnically diverse cohort: the role of neighborhood disadvantage

By Rhoads T, Neale AC, Cobos K et al.

BACKGROUND: Social support is positively associated with cognitive health, but which dimensions of support matter most and how this relationship varies across environmental contexts remains under-explored. This study examined whether neighborhood disadvantage, measured by the Area Deprivation Index (ADI), moderates the relationship between social support and cognition in an ethnocracially diverse cohort of adults aged 50 and older. METHODS: Data were analyzed from the Health and Aging Brain Study-Health Disparities (HABS-HD), which used community-based participatory research methods to recruit Non-Hispanic Black (NHB), Hispanic, and Non-Hispanic White (NHW) participants across the cognitive spectrum (normal, mild cognitive impairment, dementia). Neighborhood disadvantage was dichotomized as low versus high, and three Interpersonal Support Evaluation subscales (Tangible, Companion, and Emotional Support) were assessed. For each racial/ethnic group, a social support × ADI interaction term was tested as the primary analysis. Pooled and ADI-stratified associations between each subscale and cognition (Mini-Mental State Exam; MMSE) were examined as secondary, exploratory analyses. RESULTS: The interaction test did not provide evidence that neighborhood disadvantage moderates the association between social support and cognition in any racial/ethnic group (all p > 0.23). Independent of neighborhood disadvantage, Tangible Support was significantly and positively associated with cognition across all three groups, while Emotional Support was significantly associated with cognition among NHB and Hispanic individuals. In exploratory subgroup analyses stratified by neighborhood disadvantage, Tangible and Emotional Support were significant among NHB and Hispanic individuals in lower-disadvantage areas (ADI 1-4), and Tangible Support among NHW individuals in this stratum. No subscale predicted cognition in the highest-disadvantage areas. CONCLUSION: Tangible Support, and to a lesser extent Emotional Support, showed positive associations with cognition across ethnoracial groups, with the most consistent associations observed among NHB and Hispanic individuals in lower-disadvantage neighborhoods, though these associations attenuated in several sensitivity analyses. In exploratory subgroup analyses, significant associations were not observed among individuals residing in the most disadvantaged neighborhoods, though these findings should be interpreted cautiously given unequal strata sample sizes and warrant confirmation in future studies.

doi.org/10.3389/fneur.2026.1918066Open accessPubMed 42947860Populations