AbstractBackgroundMany studies associate late‐life community disadvantage with worse late‐life brain health. It is unknown if childhood community disadvantage is associated with late‐life brain health in racially/ethnically diverse populations.MethodKHANDLE and STAR are racially/ethnically diverse harmonized cohorts of older members of Kaiser Permanente Northern California. A random subset of participants (N = 411) underwent 3T MRI; regional brain volumes and white matter integrity were measured. Stabilized inverse probability weights were estimated to account for imaging selection based on study, race/ethnicity, baseline age, and sex/gender. Residence at birth was geocoded and linked to historical Area Deprivation Indices (ADI) from the Neighborhood Atlas. ADI is a nationally ranked percentile, where higher scores represent greater relative community disadvantage. Weighted general linear models investigated associations between continuous ADI (rescaled so 1 unit = a change of 10 percentile points of national ADI rankings) and imaging measures among participants age 65+. Separate weighted models examined associations between national ADI quintiles grouped for analysis as <20th percentile (the most advantaged quintile), 20th‐79th percentiles (middle 3 quintiles) and > = 80 (most disadvantaged quintile) and imaging measures.ResultCompared with the complete KHANDLE/STAR cohorts, the imaging sample was younger with larger proportions of Latino adults and STAR participants (Table 1). Among the imaging sample, those with ADI> = 80 were older, had lower educational attainment, were more likely to be Black and less likely to be White or Asian when compared with those with ADI<20. Increases in continuous ADI were associated with worse brain health, including lower gray matter volume (β = ‐0.05, 95% CI = ‐0.08, ‐0.02), larger lateral ventricle (β = 0.06, 95% CI = 0.02, 0.10), and larger white matter hyperintensities (β = 0.06, 95% CI = 0.03, 0.08; Table 2, Model Set 1). In models examining categorical ADI, those with ADI> = 80 (least advantaged communities) had significantly worse brain health across all measures and those with ADI = 20‐79 had larger white matter hyperintensities when compared with those with ADI<20 (ref = most advantaged quintile; Table 2, Model Set 2).ConclusionCommunity disadvantage in childhood is associated with worse brain health in late life. Future work will explore the potential pathways (e.g., individual education attainment; midlife cardiovascular risks) that may explain these associations.