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However, human evidence from large, longitudinal studies remains limited. We examine whether outdoor heat exposure is associated with incident dementia and whether socioeconomic factors moderate this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Leveraging data from the 2000 to 2020 Health and Retirement Study (\n                      <jats:italic>N\u00a0=<\/jats:italic>\n                      \u00a028,512), we assigned census\u2010tract\u2010level 5\u2010year exposure to the number of \u201cExtreme Caution\u201d (90\u00b0F to 102\u00b0F [32.2\u00b0C to 39.3\u00b0C]) and \u201cDanger+\u201d (\u2265103\u00b0F [39.4\u00b0C]) heat days, adjusting for moves. Fine\u2013Gray subdistribution hazard models estimated dementia risk, treating death as a competing event.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Compared with individuals with a low burden of \u201cDanger+\u201d heat (\u22640.2 days\/year), those with a moderate burden (0.4 to 1.8 days\/year) and a high burden (\u22657.2 days\/year) had 14% (95% confidence interval [CI]\u00a0=\u00a01.01 to 1.27) and 23% (95% CI\u00a0=\u00a01.08 to 1.40) higher risks of dementia onset, respectively. Stronger associations were found among individuals in areas with high socioeconomic disadvantage and low central air conditioning prevalence. No associations were found for \u201cExtreme Caution\u201d heat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Outdoor extreme heat may represent an important environmental risk factor for dementia, particularly among older adults living in areas characterized by structural barriers to mitigating exposure. Our findings suggest that dementia prevention efforts should consider local heat burden and prioritize strategies to reduce cumulative thermal stress. Greater attention should be directed toward identifying populations facing socioeconomic and infrastructural constraints that may benefit most from targeted heat\u2010mitigation resources and support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71857","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:02:01Z","timestamp":1792666921000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outdoor extreme heat\u2010related dementia risk and the role of socioeconomic disparities: evidence from 20 years of data on US older adults"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7587-6272","authenticated-orcid":false,"given":"Eun Young","family":"Choi","sequence":"first","affiliation":[{"name":"School of Social Work Arizona State University  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5837-8351","authenticated-orcid":false,"given":"Susanna M.","family":"Mage","sequence":"additional","affiliation":[{"name":"Leonard Davis School of Gerontology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4476-9458","authenticated-orcid":false,"given":"Jennifer A.","family":"Ailshire","sequence":"additional","affiliation":[{"name":"Leonard Davis School of Gerontology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)01208\u20103"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201041347\u20103"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2020.105909"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8306154"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.6063"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201044776\u20102"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accre.2024.11.002"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2024.116238"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010049160"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnae116"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech\u20102023\u2010220675"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010021\u201011533\u2010x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690\u2010025\u201001665\u20106"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2016.06.036"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2021.117474"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10640\u2010024\u201000881\u2010y"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195\u2010024\u201001515\u20107"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19138087"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542\u20105196(23)00216\u20104"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2018.08.014"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.1729"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.17269\/s41997\u2010020\u201000309\u20102"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315762"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.32866\/001c.116607"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-05182-1_21"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471\u2010014\u20100014\u20104"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2025.109659"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP3556"},{"key":"e_1_2_8_30_1","unstructured":"AilshireJA NamJW Vavra\u2010MusserK ChoiEY FiskCE.Contextual Data Resource (CDR): gridMET Weather Data. 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