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Measures derived from the Framingham Stroke Risk Profile, Brief Test of Adult Cognition by Telephone, and physical functioning scores from the Medical Outcomes Study 36\u2010item Short Form Health Survey were used to represent vascular burden, cognition, and intermediate activities of daily living, respectively. SDoH variables included education, income, health insurance, stress, and support from family and friends. Associations were evaluated using a composite\u2010based structural equation model (c\u2010SEM) embedded in an overall SEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Among MIDUS 2 participants with no clinical diagnosis of cognitive impairment or neurological disorder (<jats:italic>N<\/jats:italic>\u00a0=\u00a0568; mean age\u00a0=\u00a064.6), higher education, less stress, and higher income significantly contributed to the SDoH composite. Positive SDoH was associated with better physical functioning (beta\u00a0=\u00a0\u22120.21, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001) and higher cognition (beta\u00a0=\u00a00.54, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001). Significant direct effects of SDoH on vascular burden (beta\u00a0=\u00a0\u22120.12, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.05) and cognition (beta\u00a0=\u00a00.51, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001) and of vascular burden on cognition (beta\u00a0=\u00a0\u22120.28, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001) were found. Mediation analysis indicated that the unique effects of SDoH on cognition remained significant after controlling for vascular burden (beta\u00a0=\u00a00.04, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.05). After accounting for vascular burden and cognition, SDoH did not have a significant unique effect on physical functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results support the disablement theory, suggesting that factors outside of the disease model (such as SDoH factors) impact diseases that underlie physical and functional limitations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bsa3.70013","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:15:55Z","timestamp":1748333755000},"source":"Crossref","is-referenced-by-count":2,"title":["Interrelationships of social determinants with cognition, vascular health, and physical functioning"],"prefix":"10.1002","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-8481","authenticated-orcid":false,"given":"Priscilla A.","family":"Amofa\u2010Ho","sequence":"first","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0430-869X","authenticated-orcid":false,"given":"Jacob A.","family":"Fiala","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-2887","authenticated-orcid":false,"given":"Shellie\u2010Anne","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3628-766X","authenticated-orcid":false,"given":"Kathryn Marie","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashby Farmer","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Health Services Research Management &amp; Policy University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1506-9484","authenticated-orcid":false,"given":"Glenn E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/A0029857"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.3865"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171000142X"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.6.877"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/0000076-013"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.wad.0000213849.51495.d9"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glx235"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001266"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","unstructured":"National Academies of Sciences E and Medicine National Academies of Sciences E and Medicine. 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