A new study published in Neurology reveals a troubling pattern: people with lower incomes face a much higher burden of dementia-related risk factors compared to those earning more. The research, led by Dr. Eric L. Stulberg from the University of Pennsylvania, examined data from several cycles of the National Health and Nutrition Examination Survey, covering adults from early adulthood to late life.

Analyzing data from more than 13,000 people between 2015 and 2018, the researchers found that almost every major risk factor for dementia — such as high blood pressure, diabetes, smoking, and physical inactivity — was more common in individuals with lower incomes. The only exceptions were obesity, high LDL cholesterol, and traumatic brain injury, which did not show the same clear income-related pattern.

One striking finding was that among older adults living below the federal poverty level, late-life vision loss emerged as the single largest contributor to dementia risk, accounting for more than 20 percent of the potential impact. 

The study also showed that people with higher incomes tended to have fewer midlife risk factors overall, reinforcing how economic conditions shape long-term brain health.

The analysis further highlighted disparities among historically underrepresented racial and ethnic groups, who faced higher rates of midlife diabetes, obesity, physical inactivity, and late-life vision loss — all of which elevate dementia risk.

Dr. Stulberg said the findings point to a meaningful opportunity. By helping individuals reduce these modifiable risk factors now, especially in low-income and underrepresented communities, health systems may be able to significantly cut future dementia rates. He emphasized that many of these risk factors can be managed through better access to care, improved lifestyle support, and early intervention.

In simple terms, the study underscores a clear message: economic inequality isn’t just about income — it’s shaping who is more likely to develop dementia later in life.