Neurological

Cortical thinning in Alzheimer’s disease linked to neighborhood-level disadvantages

A neighborhood-level disadvantage is associated with cortical thinning in Alzheimer’s disease (AD) and cognitive decline as measured by the revised Preclinical Alzheimer’s Disease Cognitive Composite (CAC-R) test, according to study results published in Neurology.

Study researchers derived data from sub-studies of imaging from the Wisconsin Registry for Alzheimer Prevention (WRAP) and the longitudinal clinical cohort studies from the Wisconsin Alzheimer Disease Research Center. They recruited participants in these studies from the community or from recommendations from memory clinics. Participants did not have any major psychiatric, neurological, or other illnesses that could affect participation in the study.

To measure neighborhood deprivation, the study researchers used the Area Deprivation Index for the last residential address of 601 participants and compared it to the rest of their state. They collected magnetic resonance (MRI) images from each participant to estimate cortical thickness and its change between baseline and follow-up. They then calculated the annual rate of change in thickness in the AD signature meta ROI to quantify neurodegeneration.

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In addition, the researchers calculated participants’ scores on the PACC-R, including the Rey Auditory Verbal Learning Test (RAVLT-L); the Trails-Making-Test, Part B (TMT-B); and a Story Memory Memory Delayed Recall Score (SM-D).

The results showed a significant association between a high neighborhood-level disadvantage and a more rapid decline in cortical thickness in AD signature regions, which remained significant when the racial and demographic differences of the participants were controlled. Living in deprived neighborhoods was associated with significantly lower baseline PACC-R scores and a decrease in longitudinal tests (-0.67) [standard deviation, 0.13], P <0.001).

The limitations of the study included the fact that a small fraction of the participants in the longitudinal cohort lived in the 20% most deprived neighborhoods and the treatment of gender as a binary variable. In addition, the majority of the participants were non-Spanish, white and well educated.

Based on their results, the researchers concluded: “The longitudinal structural degeneration and cognitive decline observed in people from the most deprived neighborhoods suggest that increased clinical vigilance for early signs of dementia is particularly important in this vulnerable population can be.”

reference

Hunt JFV, Vogt NM, Jonaitis EM et al. Association of neighborhood context, cognitive decline, and cortical change in an unaffected cohort. Neurol. Published online April 14, 2021. doi: 10.1212 / WNL.0000000000011918

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