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Public Health.

Pablo Aguilar1,2,3, Thomas Monroe Holland4, Sam N Lockhart5

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Summary
This summary is machine-generated.

Neighborhood disadvantage impacts Alzheimer's disease (AD) risk differently across racial/ethnic groups and APOE4 status. While African Americans more frequently live in deprived areas, cognitive impacts were mainly seen in other groups, suggesting varied effects of social disadvantage.

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Area of Science:

  • Neuroscience
  • Public Health
  • Gerontology

Background:

  • Socio-economic factors influence Alzheimer's disease (AD) risk via biological pathways.
  • These risks may differ based on genetic predisposition (APOE4), race/ethnicity, and sex.
  • The Area Deprivation Index (ADI) quantifies neighborhood disadvantage.

Purpose of the Study:

  • To investigate the association between neighborhood disadvantage (ADI) and cognitive function, AD pathology, gray matter volume, and white matter hyperintensities (WMH).
  • To examine how these associations interact with race/ethnicity, sex, and APOE4 carrier status in cognitively unimpaired older adults.
  • To understand the complex interplay between social determinants of health and AD neuropathology.

Main Methods:

  • Utilized data from 1896 cognitively unimpaired older adults in the US POINTER study.
  • Assessed ADI, cognitive performance (PACC-5), gray matter volume, WMH, and AD pathology (amyloid and tau PET) using linear/logistic regressions.
  • Examined interactions between ADI and demographic/genetic factors (sex, race/ethnicity, APOE4 status).

Main Results:

  • African Americans and females were more likely to reside in deprived areas.
  • African Americans showed lower cognitive scores (PACC-5) and gray matter volume.
  • APOE4 carriers had higher amyloid burden, but in deprived areas, showed increased WMH and lower amyloid burden, indicating a vascular component.
  • Race interacted with ADI on cognitive scores and tau pathology; APOE4 status interacted with ADI on WMH and amyloid burden.

Conclusions:

  • Neighborhood disadvantage disproportionately affects African Americans but has varied cognitive interaction effects across racial/ethnic groups.
  • APOE4 carriers from disadvantaged neighborhoods exhibit a higher vascular component (WMH) alongside potentially lower amyloid pathology.
  • Findings suggest that social disadvantages may have differential impacts on AD risk and progression depending on individual and group characteristics.