Over‐Representation of Extremely Wealthy Neighborhood Social Exposomes for Brain Donors within Alzheimer’s Disease Research Center Brain Banks assessed by the Neighborhoods Study

Abstract Background Adverse social exposome (indexed by national Area Deprivation Index [ADI] 80‐100 or ‘high ADI’) is linked to structural inequities and increased risk of Alzheimer’s disease neuropathology. Twenty percent of the US population resides within high ADI areas, predominantly in inner cities, tribal reservations and rural areas. The percentage of brain donors from high ADI areas within the Alzheimer’s Disease Research Center (ADRC) brain bank system is unknown. Objective Determine ADI for brain donors from 21 ADRC sites as part of the on‐going Neighborhoods Study. Methods All brain donors in participating ADRC sites with NACC neuropathology data and personal identifiers for ADI linkage (N = 8,637) were included (Figure 1). Geocoded donor addresses were linked to time‐concordant ADI percentiles for year of death. Results Overall, only 5.6% of ADRC brain donors (N = 488) resided in a high ADI (disadvantaged) neighborhood at death. The remaining donors resided in more advantaged neighborhoods, with nearly 40% of donors living in the wealthiest quintile of neighborhoods, and over 300 brain donors originating from the wealthiest 1% of US neighborhoods (Figure 2). Donors from high ADI (disadvantaged) neighborhoods identified as 87% White (n = 424), 11% Black (55), 1% Multiracial (6) and <1% other/unknown race (3), with 1% Hispanic (5). None identified as American Indian/Alaska Native or Native Hawaiian/Pacific Islander/Asian. In comparison, donors from low ADI neighborhoods were 94% White (n = 7680), 3% Black (273), 1% Multiracial (75), <1% American Indian/Alaska Native (11), <1% Native Hawaiian/Pacific Islander/Asian (60), and <1% other/unknown race (50), with 3% Hispanic (230). Sex distribution was similar (54%, 51% female, respectively). Inclusion of high ADI donors varied dramatically across the 21 ADRC brain banks from a low of 0.6% to high of 20% of all a site’s donors (Figure 3). Conclusions ADI was determined for over 8,600 brain donors in the ADRC system, demonstrating a marked over‐representation of donors from very low ADI (extremely wealthy) neighborhoods, in addition to site‐to‐site variability. This is the first time a comprehensive cross‐sectional social exposome assessment of this nature has been performed, opening windows for additional mechanistic study of the social exposome on brain pathology. Life course ADI assessments are on‐going.

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Publication Details

Journal
Alzheimer s & Dementia
Published
2024-12-01
DOI
https://doi.org/10.1002/alz.087530
Primary Topic
Health, Environment, Cognitive Aging
Type
article
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article

Over‐Representation of Extremely Wealthy Neighborhood Social Exposomes for Brain Donors within Alzheimer’s Disease Research Center Brain Banks assessed by the Neighborhoods Study

Anja Soldan, Melissa Lamar, Richard J. Perrin, Mary Sano et al.
Alzheimer s & Dementia
Health, Environment, Cognitive Aging
article

Over‐Representation of Extremely Wealthy Neighborhood Social Exposomes for Brain Donors within Alzheimer’s Disease Research Center Brain Banks assessed by the Neighborhoods Study

Anja Soldan, Melissa Lamar, Richard J. Perrin, Mary Sano, Judith Neugroschl, David Alan Bennett, Shannon L. Risacher, Robert A. Rissman, Suzanne Craft, Randall L. Woltjer, Carmen I. Carrión, Raina Croff, Barbara B. Bendlin, Andrew J. Saykin, Jill K. Morris, Lisa L. Barnes, Serggio Lanata, W. Ryan Powell, Jennifer H. Lingler, Liana G. Apostolova, David L. Sultzer, Paola Espinoza, Corinne Pettigrew, Bruce L. Miller, Erin L. Abner, Julia Kofler, Geidy E. Serrano, Thomas K. Karikari, Henry L. Paulson, James R. Bateman, Anna Kucharska‐Newton, Felicia C. Goldstein, Cyrus A. Raji, Michael L. Alosco, Anthony Fabio, Karyn Marsh, Yixuan Cheng, Maureen K. O’Connor, Kelly M. Bakulski, Samuel N. Lockhart, Rebecca J. Lepping, Oanh L. Meyer, Amy Kind, Aimee Pierce, Joshua Chodosh, Victor W. Henderson, Carolyn W. Zhu, Rachel A. Whitmer, Brittney Lyons Boone, Amanda DeWitt, Jessica Sharrow, Luke Chamberlain, Thomas G. Beach, James B. Brewer, Thomas Wisniewski, Eric M. Reiman, Jonathan D. Mahnken, Sarah Tomaszewski Farias
article en

Abstract

Abstract Background Adverse social exposome (indexed by national Area Deprivation Index [ADI] 80‐100 or ‘high ADI’) is linked to structural inequities and increased risk of Alzheimer’s disease neuropathology. Twenty percent of the US population resides within high ADI areas, predominantly in inner cities, tribal reservations and rural areas. The percentage of brain donors from high ADI areas within the Alzheimer’s Disease Research Center (ADRC) brain bank system is unknown. Objective Determine ADI for brain donors from 21 ADRC sites as part of the on‐going Neighborhoods Study. Methods All brain donors in participating ADRC sites with NACC neuropathology data and personal identifiers for ADI linkage (N = 8,637) were included (Figure 1). Geocoded donor addresses were linked to time‐concordant ADI percentiles for year of death. Results Overall, only 5.6% of ADRC brain donors (N = 488) resided in a high ADI (disadvantaged) neighborhood at death. The remaining donors resided in more advantaged neighborhoods, with nearly 40% of donors living in the wealthiest quintile of neighborhoods, and over 300 brain donors originating from the wealthiest 1% of US neighborhoods (Figure 2). Donors from high ADI (disadvantaged) neighborhoods identified as 87% White (n = 424), 11% Black (55), 1% Multiracial (6) and <1% other/unknown race (3), with 1% Hispanic (5). None identified as American Indian/Alaska Native or Native Hawaiian/Pacific Islander/Asian. In comparison, donors from low ADI neighborhoods were 94% White (n = 7680), 3% Black (273), 1% Multiracial (75), <1% American Indian/Alaska Native (11), <1% Native Hawaiian/Pacific Islander/Asian (60), and <1% other/unknown race (50), with 3% Hispanic (230). Sex distribution was similar (54%, 51% female, respectively). Inclusion of high ADI donors varied dramatically across the 21 ADRC brain banks from a low of 0.6% to high of 20% of all a site’s donors (Figure 3). Conclusions ADI was determined for over 8,600 brain donors in the ADRC system, demonstrating a marked over‐representation of donors from very low ADI (extremely wealthy) neighborhoods, in addition to site‐to‐site variability. This is the first time a comprehensive cross‐sectional social exposome assessment of this nature has been performed, opening windows for additional mechanistic study of the social exposome on brain pathology. Life course ADI assessments are on‐going.

Alzheimer s & DementiaVol. 20(S7)
Boston University (US), University of North Carolina at Chapel Hill (US), University of Southern California (US), Rush University Medical Center (US), University of Wisconsin–Madison (US), University of Kentucky (US), Johns Hopkins University (US), Emory University (US), Oregon Health & Science University (US), University of Pittsburgh (US), Palo Alto University (US), University of California, San Francisco (US), University of California, Irvine (US), Washington University in St. Louis (US), University of Michigan (US), Johns Hopkins Medicine (US), Yale University (US), University of California San Diego (US), Mount Sinai Hospital (US), Mallinckrodt (United States) (US), University Memory and Aging Center (US), University of Kansas Medical Center (US), Banner Sun Health Research Institute (US), Banner Alzheimer’s Institute, Indiana University School of Medicine, Wake Forest University (US), Indiana University – Purdue University Indianapolis (US), New York University (US), University of California, Davis (US), Southern States University (US), Stanford University (US), Icahn School of Medicine at Mount Sinai (US)
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Health, Environment, Cognitive Aging
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