{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:51:10Z","timestamp":1791568270828,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["AG074302"],"award-info":[{"award-number":["AG074302"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>African American adults experience a disproportionate burden of dementia, shaped by structural and clinical factors that remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify associations between multimorbidity, polypharmacy, and cognition in the context of neighborhood disadvantage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a cross-sectional analysis of 348 African American adults aged 45\u201392 years (mean 64.3 years; 73.6% female) from the Aging Research Characterizing Health Exposome via Social drivers (ARCHES) cohort. Comorbidity burden was assessed using a modified Charlson Comorbidity Index (CCI), polypharmacy as \u22655 medications, and neighborhood disadvantage using the Area Deprivation Index (ADI). Linear regression estimated associations with a Preclinical Alzheimer\u2019s Cognitive Composite (PACC). The polypharmacy model included modified CCI as a covariate, and effect modification by ADI was assessed using an interaction term between polypharmacy and ADI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher modified CCI was associated with lower cognitive performance (B = \u22120.071; 95% CI: \u22120.130, \u22120.012). Polypharmacy was not independently associated with cognition after modified CCI adjustment (B = \u22120.081; \u03b2 = \u22120.057; p = 0.257). No significant ADI interaction was found (p = 0.064).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07334648261491344","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:53:42Z","timestamp":1791399222000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimorbidity, Polypharmacy, and Neighborhood Disadvantage as Determinants of Cognitive Performance in the ARCHES Cohort"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6407-2212","authenticated-orcid":false,"given":"Dagem","family":"Gebremichael","sequence":"first","affiliation":[{"name":"Washington University in St. Louis"},{"name":"Addis Ababa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6514-0502","authenticated-orcid":false,"given":"Semere","family":"Bekena","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9022-2317","authenticated-orcid":false,"given":"Ramkrishna K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis I. 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