Social Determinants of Health (SDOH) and Cognition: A Scoping Review.

Abstract

To map the evidence of disparities in cognition across different social determinants of health (SDOH), examine how SDOH are measured in the context of research on cognitive outcomes and identify knowledge gaps. PubMed, the Cochrane Library, and Web of Science were searched. We included peer-reviewed studies of adults that examined SDOH as primary exposures in relation to cognitive outcomes, and described a SDOH framework or definition in the context of cognition. Non-human studies, case reports, case series, editorials, protocols, and abstract-only records were excluded. Ninety-one records were included. Most of the included studies were conducted in the US and the most frequently used framework was the Healthy People (2030) framework. Among studies examining a single SDOH indicator, the Area Deprivation Index (ADI) was the most used measure. Most of the existing research failed to explain the concept of SDOH and lacked a framework to guide the inclusion and interpretation of SDOH indicators. SDOH measures were heterogeneous across studies, with many examining only a single indicator and limited use of multidimensional approaches. This heterogeneity made findings challenging to compare. More research is needed on multidimensional SDOH and cognition in various racial/ethnic groups and less-studied geographic and cultural contexts, under explicit SDOH frameworks.