Social determinants of health modify the association of Alzheimer's disease pathology with cognitive abilities but not of apolipoprotein E-ε4 with Alzheimer's disease pathology.

IF 4.4 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2026-10-09 eCollection Date: 2026-10-01 DOI:10.1002/dad2.70462

Naomi V Ferreira, Laiss Bertola, Regina S Paradela, Aline M Ciciliati, Caroline M Silva, Lea T Grinberg, Carlos A Pasqualucci, Vitor R Paes, Eduardo Ferriolli, Michel Naslavsky, Renata P Leite, Claudia K Suemoto

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引用次数: 0

Abstract

Introduction: Apolipoprotein E (APOE) -ε4 and social determinants of health (SDoH) are major Alzheimer's disease (AD) risk factors, yet whether SDoH modify the relationship between APOE-ε4, AD pathology, and cognition remains unclear.

Methods: Using Biobank for Aging Studies (BAS) data, we assessed APOE-ε4 using polymerase chain reaction (PCR), AD pathology using immunohistochemistry, and cognitive abilities using Clinical Dementia Rating - Sum of Boxes (CDR-SB).

Results: In 1,193 individuals (mean [SD] age 73.4 [13.0] years; 50.1% women; 65.4% White), APOE-ε4 carriers had higher odds of AD pathology (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.85; 5.51; p < 0.001), and AD pathology was associated with poorer cognition (β = 8.07, 95% CI: 7.47; 8.67; p < 0.001). SDoH modified this pathology-cognition association (p = 0·002), which was stronger in the unfavorable (β = 9.09, 95% CI: 8.00; 10.19, p < 0.001) versus the favorable SDoH profile (β = 6.39, 95% CI: 5.42; 7.37; p < 0.001). SDoH did not modify the APOE-ε4-pathology association (p = 0.806), and no race effect modification was observed.

Discussion: AD pathology was more strongly associated with poorer cognition in unfavorable SDoH profiles, highlighting SDoH as targets for AD prevention.

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健康的社会决定因素改变了阿尔茨海默病病理与认知能力的关系，但没有改变载脂蛋白E-ε4与阿尔茨海默病病理的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.