Social determinants of health but not global genetic ancestry predict dementia prevalence in Latin America.

Autor: Llibre-Guerra JJ; Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA., Jiang M; Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland., Acosta I; Laboratory of the Dementias, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.; National Autonomous University of Mexico, Mexico City, Mexico., Sosa AL; Laboratory of the Dementias, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.; National Autonomous University of Mexico, Mexico City, Mexico., Acosta D; Internal Medicine Department, Universidad Nacional Pedro Henriquez Ureña (UNPHU), Geriatric Section, Santo Domingo, Dominican Republic., Jimenez-Velasquez IZ; Internal Medicine Department, Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA., Guerra M; Instituto de la Memoria Depresion y Enfermedades de Riesgo IMEDER, Lima, Perú., Salas A; Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela., Rodriguez Salgado AM; Global Brain Health Institute, University of San Francisco California, San Francisco, California, USA., Llibre-Guerra JC; Department of Neurology, Hospital de Salamanca, Salamanca, Spain., Sánchez ND; Dementia Research Unit, Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, Cuba., Prina M; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK., Renton A; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Albanese E; Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland., Yokoyama JS; Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA., Llibre Rodriguez JJ; Dementia Research Unit, Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, Cuba.
Jazyk: angličtina
Zdroj: Alzheimer's & dementia : the journal of the Alzheimer's Association [Alzheimers Dement] 2024 Jul; Vol. 20 (7), pp. 4828-4840. Date of Electronic Publication: 2024 Jun 05.
DOI: 10.1002/alz.14041
Abstrakt: Introduction: Leveraging the nonmonolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia prevalence in Latin American populations.
Methods: Community-dwelling participants aged 65 and older (N = 3808) from Cuba, Dominican Republic, Mexico, and Peru completed the 10/66 protocol assessments. Dementia was diagnosed using the cross-culturally validated 10/66 algorithm. Multivariate linear regression models adjusted for SDoH were used in the main analysis. This study used cross-sectional data from the 1066 population-based study.
Results: Individuals with higher proportions of Native American (>70%) and African American (>70%) ancestry were more likely to exhibit factors contributing to worse SDoH, such as lower educational levels (p < 0.001), lower socioeconomic status (p < 0.001), and higher frequency of vascular risk factors (p < 0.001). After adjusting for measures of SDoH, there was no association between ancestry proportion and dementia probability, and ancestry proportions no longer significantly accounted for the variance in cognitive performance (African predominant p = 0.31 [-0.19, 0.59] and Native predominant p = 0.74 [-0.24, 0.33]).
Discussion: The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia prevalence in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to effectively reduce dementia risk in these communities.
Highlights: Countries in Latin America express a large variability in social determinants of health and levels of admixture. After adjustment for downstream societal factors linked to SDoH, genetic ancestry shows no link to dementia. Population ancestry profiles alone do not influence cognitive performance. SDoH are key drivers of racial disparities in dementia and cognitive performance.
(© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
Databáze: MEDLINE
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