{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:27:10Z","timestamp":1788380830016,"version":"build-2803163510"},"reference-count":75,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p>It is important to understand the socioeconomic and medical determinants of subjective cognitive decline (SCD) at a population level in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The primary outcomes are state\u2010level rates of SCD and SCD\u2010related functional impairment in adults aged \u2265 45, both measured in the Behavioral Risk Factor Surveillance System from 2016 to 2022. The exposures are state\u2010level rates of poverty, unemployment, homelessness, college education, racial and ethnic minorities, uninsurance, smoking, hypertension, diabetes, and obesity as well as household income and physician density.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The strongest state\u2010level associations with rates of SCD were the prevalence of diabetes (rho\u00a0=\u00a00.64), hypertension (rho\u00a0=\u00a00.59), and poverty (rho\u00a0=\u00a00.58; all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and with SCD\u2010related functional impairment were prevalence of poverty (rho\u00a0=\u00a00.71), diabetes (rho\u00a0=\u00a00.68), and hypertension (rho\u00a0=\u00a00.53; all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>This study highlights critical links between SCD and socioeconomic and medical determinants in adults aged \u2265 45 in the United States, including the prevalence of poverty, diabetes, and hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>State\u2010level analysis reveals socioeconomic and medical risk factors for subjective cognitive decline (SCD) at a population level.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The prevalence of poverty is a critical contributor to the state\u2010level prevalence of SCD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The prevalence of diabetes and hypertension are also strong state\u2010level determinants of SCD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Addressing the burden of cognitive decline at the population level necessitates targeting socioeconomic and medical factors.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.14220","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T06:34:35Z","timestamp":1727764475000},"page":"7567-7579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Socioeconomic and medical determinants of state\u2010level subjective cognitive decline in the United States"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-8597","authenticated-orcid":false,"given":"Adam","family":"de Havenon","sequence":"first","affiliation":[{"name":"Department of Neurology Center for Brain and Mind Health Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric L.","family":"Stulberg","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City 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