학술논문
Dementia, dementia's risk factors and premorbid brain structure are concentrated in disadvantaged areas: National register and birth-cohort geographic analyses.
Document Type
Academic Journal
Author
Reuben A; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.; Richmond-Rakerd LS; Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA.; Milne B; Centre for Methods and Policy Application in Society Sciences, University of Auckland, Auckland, New Zealand.; Shah D; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Pearson A; Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, Michigan, USA.; Department of Public Health, University of Otago, Wellington, New Zealand.; Hogan S; Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand.; Ireland D; Brain Health Research Centre, Department of Psychology, University of Otago, Dunedin, New Zealand.; Keenan R; Brain Health Research Centre, Department of Psychology, University of Otago, Dunedin, New Zealand.; Knodt AR; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Melzer T; Department of Medicine, University of Otago, Christchurch, New Zealand.; Poulton R; Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand.; Ramrakha S; Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand.; Whitman ET; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Hariri AR; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Moffitt TE; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.; King's College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK.; PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway.; Caspi A; Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.; King's College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK.; PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway.
Source
Publisher: John Wiley & Sons, Ltd Country of Publication: United States NLM ID: 101231978 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-5279 (Electronic) Linking ISSN: 15525260 NLM ISO Abbreviation: Alzheimers Dement Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Dementia risk may be elevated in socioeconomically disadvantaged neighborhoods. Reasons for this remain unclear, and this elevation has yet to be shown at a national population level.
Methods: We tested whether dementia was more prevalent in disadvantaged neighborhoods across the New Zealand population (N = 1.41 million analytic sample) over a 20-year observation. We then tested whether premorbid dementia risk factors and MRI-measured brain-structure antecedents were more prevalent among midlife residents of disadvantaged neighborhoods in a population-representative NZ-birth-cohort (N = 938 analytic sample).
Results: People residing in disadvantaged neighborhoods were at greater risk of dementia (HR per-quintile-disadvantage-increase = 1.09, 95% confidence interval [CI]:1.08-1.10) and, decades before clinical endpoints typically emerge, evidenced elevated dementia-risk scores (CAIDE, LIBRA, Lancet, ANU-ADRI, DunedinARB; β's 0.31-0.39) and displayed dementia-associated brain structural deficits and cognitive difficulties/decline.
Discussion: Disadvantaged neighborhoods have more residents with dementia, and decades before dementia is diagnosed, residents have more dementia-risk factors and brain-structure antecedents. Whether or not neighborhoods causally influence risk, they may offer scalable opportunities for primary dementia prevention.
(© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
Methods: We tested whether dementia was more prevalent in disadvantaged neighborhoods across the New Zealand population (N = 1.41 million analytic sample) over a 20-year observation. We then tested whether premorbid dementia risk factors and MRI-measured brain-structure antecedents were more prevalent among midlife residents of disadvantaged neighborhoods in a population-representative NZ-birth-cohort (N = 938 analytic sample).
Results: People residing in disadvantaged neighborhoods were at greater risk of dementia (HR per-quintile-disadvantage-increase = 1.09, 95% confidence interval [CI]:1.08-1.10) and, decades before clinical endpoints typically emerge, evidenced elevated dementia-risk scores (CAIDE, LIBRA, Lancet, ANU-ADRI, DunedinARB; β's 0.31-0.39) and displayed dementia-associated brain structural deficits and cognitive difficulties/decline.
Discussion: Disadvantaged neighborhoods have more residents with dementia, and decades before dementia is diagnosed, residents have more dementia-risk factors and brain-structure antecedents. Whether or not neighborhoods causally influence risk, they may offer scalable opportunities for primary dementia prevention.
(© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)