Emerging brain MRI research suggests that people in disadvantaged neighborhoods have a higher brain age gap (BAG), higher white matter hyperintensity volume (WMHV) and lower total brain volume.
For the retrospective study, recently published in Radiology, researchers reviewed brain MRI data as well as area deprivation index (ADI) data (which provides geospatially determined assessment of neighborhood level disadvantage) for 2,826 patients (mean age of 53). For the ADI assessment, the study authors noted that 116 patients at the national level and 129 patients at the state level were deemed to live in the most disadvantaged neighborhoods.
The researchers found that patients in the most disadvantaged neighborhoods as per the national ADI had a significantly higher brain age gap (BAG) of 2.72 years. The BAG was 3.02 for those in the most disadvantaged neighborhoods in the state of Wisconsin, according to the study authors.
“This association empirically aligns with previous work suggesting that BAG reflects cumulative exposure to physiologic and psychosocial stressors. (Brain age) models are increasingly conceptualized as integrative markers of multisystem biologic wear and tear that converge on neuroanatomic decline. Accordingly, this association between ADI and elevated BAG may reflect the accumulation of chronic environmental adversity,” noted lead study author Ethan H. Willbrand, BA, who is affiliated with the medical scientist training program and the Department of Radiology at the University of Wisconsin School of Medicine in Madison, Wisc., and colleagues.
Is There a Link Between Higher White Matter Hyperintensity Volume and Living in Disadvantaged Neighborhoods?
The study authors also observed a significantly higher WMHV associated with those who reside in the most disadvantaged neighborhoods in comparison to those living in the least disadvantaged areas (8.38 mL vs. 5.25 mL). The approximately 37 percent difference in WMHV may be attributed to a combination of socioeconomic and vascular risks impacting prefrontal and subcortical brain regions, according to the researchers.
“These brain areas, particularly the caudate and (dorsolateral prefrontal cortex), are vulnerable to vascular insults and chronic stress and are implicated in executive function and reward processing. This suggests that neighborhood-level adversity may enhance the neuroanatomic consequences of vascular pathologic conditions, consistent with a ‘double-hit”’ model in which structural inequity and cardiometabolic risk synergistically accelerate neural vulnerability,” posited Willbrand and colleagues.
Three Key Takeaways
• Neighborhood disadvantage tracks with accelerated brain aging. Patients from the most disadvantaged areas showed a brain age gap roughly 2.7–3 years higher than peers in less disadvantaged areas — suggesting cumulative socioeconomic and psychosocial stress may leave a measurable imprint on brain structure independent of chronological age.
• Vascular/white matter burden is notably elevated. WMHV was about 37 percent higher (8.38 mL vs. 5.25 mL) in the most disadvantaged group, pointing to a "double-hit" pattern where structural inequity and cardiometabolic risk may compound to accelerate small-vessel disease, particularly in regions tied to executive function.
• Effects appear diffuse, not focal. The modest but consistent reduction in total brain volume suggests socioeconomic disadvantage relates to global, systemic neuroanatomic effects (consistent with chronic stress/inflammation pathways) rather than damage confined to one region. This finding may reinforce that ADI could be a useful contextual factor when interpreting brain imaging findings alongside traditional risk factors.
Do Socioeconomic Stressors Contribute to Reduced Brain Volume?
The study findings also revealed that the cohort living in the most disadvantaged neighborhoods had a slightly lower total brain volume (TBV) (1,143 mL vs. 1,151 mL).
“Because TBV reflects global cortical and subcortical integrity, these findings suggest that socioeconomic disadvantage on its own is linked to diffuse neuroanatomic systems rather than regionally isolated processes. Such diffuse effects are consistent with models of chronic stress exposure, glucocorticoid dysregulation, and low-grade systemic inflammation, all of which have been implicated in accelerated brain aging and cortical thinning,” added Willbrand and colleagues.
Final Notes
(Editor’s note: For related content, see “New MRI Study Examines Impact of Disparities with Childhood Adversity Exposure on Brain Development,” “Nine Takeaways from New Article Examining Health Equity in the Radiology Field” and “Study: Black Patients Less Likely Than Others to Receive MRI Assessment of Cognitive Impairment.”)
In regard to study limitations, the study authors acknowledged the data was drawn from one state and there was a lack of information on possible confounding factors such as smoking, exercise, drug use, chronic disease and educational attainment. The researchers also noted a relatively small cohort for the most disadvantaged group in the study.
