Social vulnerability shapes deep clinical phenotypes and brain health in aging and dementia across Latin America
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Abstract INTRODUCTION Adverse social conditions across the life course influence brain aging and dementia, yet their compounded impact on clinical phenotypes remains underexplored, particularly in Latin America, where social inequality and dementia burden are high. alz71534-sec-0010 METHODS We studied 3941 individuals from six Latin American countries, including cognitively unimpaired controls (CU), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). A life‐course questionnaire captured eight domains of social vulnerability, used to derive a social vulnerability index and latent vulnerability profiles. Brain health was characterized across 37 cognitive, functional, mental health, and dementia severity indicators. alz71534-sec-0020 RESULTS Higher vulnerability was mostly associated with executive and memory deficits in CU, cognitive and functional impairment in AD, and social cognition and neuropsychiatric symptoms in FTLD. Multidimensional brain health was affected across groups. alz71534-sec-0030 DISCUSSION Compounded social vulnerability is a key determinant of clinical expression in aging and dementia, underscoring the need for life‐course–informed and equity‐oriented dementia models. alz71534-sec-0040 Highlights Compounded social vulnerability affects multidimensional brain health phenotypes. In cognitively unimpaired controls (CU), effects were more marked in memory and executive function domains. For Alzheimer's disease (AD), vulnerability most affec
Abstract
Abstract INTRODUCTION Adverse social conditions across the life course influence brain aging and dementia, yet their compounded impact on clinical phenotypes remains underexplored, particularly in Latin America, where social inequality and dementia burden are high. alz71534-sec-0010 METHODS We studied 3941 individuals from six Latin American countries, including cognitively unimpaired controls (CU), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). A life‐course questionnaire captured eight domains of social vulnerability, used to derive a social vulnerability index and latent vulnerability profiles. Brain health was characterized across 37 cognitive, functional, mental health, and dementia severity indicators. alz71534-sec-0020 RESULTS Higher vulnerability was mostly associated with executive and memory deficits in CU, cognitive and functional impairment in AD, and social cognition and neuropsychiatric symptoms in FTLD. Multidimensional brain health was affected across groups. alz71534-sec-0030 DISCUSSION Compounded social vulnerability is a key determinant of clinical expression in aging and dementia, underscoring the need for life‐course–informed and equity‐oriented dementia models. alz71534-sec-0040 Highlights Compounded social vulnerability affects multidimensional brain health phenotypes. In cognitively unimpaired controls (CU), effects were more marked in memory and executive function domains. For Alzheimer's disease (AD), vulnerability most affects cognitive and functional ability performance. In frontotemporal lobar degeneration (FTLD), effects concentrate on social cognition and neuropsychiatric domains. Vulnerability is associated with poorer multidimensional brain health. bullet alz71534-list-0001 highlights