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Social determinants of dementia: A scoping review
Sebastian Walsh2025
Matthias KleeEsther K. Hui
Average · 50th percentile
15 citations · Psychiatry and Mental health
Open AccessCognitive Aging: From Educational Opportunities to Individual Risk Profiles

TLDR

Where and how people live, work, and interact with others can raise or lower their chances of getting dementia. Things like education and air pollution are especially important, and more research is needed to understand other social factors.

Summary

1 Study Aim

The main goal of this scoping review is to map out what is currently known about how social factors—called social determinants of dementia (SDOD)—affect the risk of developing dementia. The authors aim to identify which social factors have strong evidence linking them to dementia, highlight areas where evidence is missing or weak, and suggest directions for future research. Simply put: The study wants to find out which parts of our social lives make dementia more or less likely, and where more research is needed.

2 Study Design

The authors conducted a two-stage scoping review. First, they reviewed existing systematic reviews about social determinants and dementia. Second, they searched for new primary studies to fill in gaps not covered by those reviews. They included studies that measured social factors before dementia developed and tracked who later got dementia. The review covered six main areas: food environment, physical environment and pollution, housing and sanitation, income and work, social inclusion and ethnicity, and education. Most evidence came from high-income countries. Simply put: The researchers looked at lots of studies and reviews to see how different social factors are linked to dementia, focusing on what we know and what we still need to learn.

3 Findings

The review shows strong and consistent evidence that low education, air pollution, and low socioeconomic status (meaning less money, lower-status jobs, or living in poorer areas) increase dementia risk. There is also evidence that being part of certain ethnic groups, experiencing social isolation, or having unstable housing can raise risk, but research in these areas is less complete. Some social factors, like food insecurity and poor housing, need more study. Most research comes from wealthier countries, so findings may not apply everywhere. The authors recommend more studies in under-researched areas, better ways to measure social factors, and longer follow-up periods. They also suggest that future policies to prevent dementia should address a wider range of social factors, not just individual behaviors. Simply put: The study found that things like less schooling, dirty air, and being poorer make dementia more likely, but we need more research on other social issues and in different countries.

Abstract

Dementia risk is influenced by the social conditions in which people live. These social determinants of dementia (SDOD) are potential targets for prevention. We conducted a comprehensive scoping review to identify current evidence on SDOD in two stages: (1) review of systematic reviews on SDOD; and (2) review of primary literature to address identified gaps in the evidence base. Of the 3445 articles screened, 26 reviews and 74 primary studies were included. Evidence from reviews provide clear and consistent patterns for some SDOD (e.g., education, air pollution, socioeconomic status, ethnicity), while evidence for others is still emerging (e.g., housing quality/stability), or lacking entirely (e.g., incarceration). SDOD are important over the life course. Additional evidence is needed for understudied domains and to unravel the complex interactions between determinants, whilst education and air pollution stand out as key targets for public health interventions. HIGHLIGHTS: There is clear and consistent evidence for some social determinants of dementia (SDOD) across diverse domains. Evidence for other SDOD (e.g., housing, incarceration) is still emerging or lacking. Evidence for SDOD comes mainly from high-income countries. The complex intercorrelations between SDODs demand a nuanced analytical approach. Standardized measures and longer follow-up to study SDOD are recommended.

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