Association of neighborhood deprivation with Alzheimer's disease pathology, brain structure, and cognition by race and ethnicity, sex, and APOE ε4 status
Pablo Aguilar‐Dominguez, Carmen‐Maria Colceriu, Thomas Monroe Holland, Samuel N Lockhart, Joseph C. Masdeu, Lycia Tramujas Vasconcellos Neumann, Heather M Snyder, Laura D Baker, Alexandre Bejanin, Susan M. Landau, Eider M. Arenaza‐UrquijoAbstract
INTRODUCTION
We investigated associations of Area Deprivation Index (ADI) with Alzheimer's disease (AD) ‐related outcomes by biological and social factors in at‐risk older adults.
METHODS
A total of 1880 U.S. POINTER participants with ADI and cognition (Preclinical Alzheimer's Cognitive Composite [PACC]) were included. 868 had amyloid, tau positron emission tomography (PET), white matter hyperintensities (WMH), and/or gray matter volumes. We conducted exploratory, linear regression models testing ADI interactions with sex, race and ethnicity, and apolipoprotein E (APOE) ε4, adjusting for age and education.
RESULTS
“White/European American” and “Hispanic/Latinx/Spanish” showed lower cognitive scores with higher ADI, while “White/European American” showed the highest cognitive scores across ADI levels. APOE ε4 carriers from high‐ADI areas showed higher WMH and tau, and “Hispanic/Latinx/Spanish” from more deprived areas showed higher WMH. Females from moderate‐ADI areas showed higher tau. Amyloid burden was higher among low‐ADI APOE ε4 carriers.
DISCUSSION
Differential associations of ADI with AD‐related outcomes across biological and social factors may reflect systemic health disparities and study design.