A – 71 Exploring The Relationship Between Social Determinants of Health and Psychiatric Outcomes on Cognitive Reserve in Black Older Adults

Abstract Objective This study explored the relationship between area deprivation, childhood adversity, and health literacy on cognitive and psychiatric outcomes among Black older adult patients referred for outpatient neuropsychological evaluation of possible memory impairment. Method This study utilized cross-sectional data from 111 older adult Black patients evaluated for possible cognitive impairment at a large Midwestern academic medical center. The sample was 62.2% female with MeanAge=64.17 (SD=8.30), MeanEducation=12.63 (SD=2.90), and MeanIQ=86.02 (SD=9.96). All patients were administered a neuropsychological battery that included the Montreal Cognitive Assessment (MoCA), Adverse Childhood Experiences (ACEs) Questionnaire, Perceived Stress Scale (PSS), Short Assessment of Health Literacy (SAHL-E), and Beck Anxiety Inventory (BAI). Area Deprivation Indices (ADI) were collected for each patient based on 2022 national ADI percentiles. A series of multiple linear regressions analyzed the influence of ACEs, ADI, and SAHL-E on MoCA total scores and current perceived stress and anxiety symptoms. Results Health literacy significantly predicted global cognition on the MoCA (R2=.23; F(3,107)=10.795, p<.001), whereas ADI and ACEs did not. ADI, ACEs, and Health Literacy did not significantly predict current perceived stress (R2=.05, F(3,102)=1.825, p=.147). Finally, ACEs significantly predicted current anxiety symptoms (R2=.17, F(3,105)=7.338, p<.001), while ADI and Health Literacy did not. Conclusion Findings indicate that health literacy may be a protective factor against cognitive decline in older age Black patients, whereas current anxiety symptoms may be influenced by early childhood adversity. Community-level interventions addressing health promotion and childhood adversity may have a positive effect on neuropsychological outcomes among this population.