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Basic Science and Pathogenesis
Grace C George1, Sarah A Keller1, W Ryan Powell1
1Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 23, 2025
Summary
Disadvantaged neighborhoods, measured by the Area Deprivation Index (ADI), are linked to increased odds of Cerebrovascular Disease (CVD) neuropathology. This study highlights the impact of neighborhood deprivation on brain health in a national brain donor cohort.
Area of Science:
- Neuropathology
- Public Health
- Social Epidemiology
Background:
- Alzheimer's Disease and related dementias (ADRD) are complex and linked to socioeconomic factors.
- Structural inequities, such as living in disadvantaged neighborhoods (indexed by Area Deprivation Index - ADI), increase ADRD risk.
- Cerebrovascular Disease (CVD) is a common co-morbidity in dementia, but its relationship with neighborhood deprivation is understudied.
Purpose of the Study:
- To investigate the association between neighborhood deprivation (ADI) and the presence of Cerebrovascular Disease (CVD) neuropathology.
- To analyze data from a national sample of brain bank donors within the Neighborhoods Study.
- To understand if higher neighborhood deprivation predicts CVD in a diverse cohort.
Main Methods:
- Utilized data from 7,187 brain donor participants across 21 Alzheimer's Disease Research Centers (ADRC).
- Linked donor addresses at death to national ADI percentiles, categorized into tertiles.
- Assessed CVD neuropathology (infarcts, hemorrhages, microinfarcts, white matter rarefaction) using NACC data and logistic regression, adjusting for sex, age, and APOE status.
Main Results:
- Approximately 25% of donors resided in high deprivation areas; 52% exhibited CVD.
- Increased ADI significantly predicted higher odds of CVD neuropathology (OR = 1.16, p < .001).
- Donors in the lowest deprivation tertile had significantly less CVD (48%) compared to middle (54.6%) and highest (54.7%) tertiles.
Conclusions:
- Higher neighborhood deprivation is associated with increased odds of CVD neuropathology in a national brain donor cohort.
- Findings suggest a link between socioeconomic disadvantage and cerebrovascular pathology.
- Further research is needed to elucidate the mechanisms driving these associations.
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