Association of Neighborhood-Level Disadvantage With Alzheimer Disease Neuropathology

作者：W. Ryan Powell, William R. Buckingham, Jamie L. Larson, Leigha H. Vilen, Menggang Yu, M. Shahriar Salamat, Barbara B. Bendlin, Robert A. Rissman, Amy Kind · 发表于：JAMA Network Open · 年份：2020 · DOI：10.1001/jamanetworkopen.2020.7559 · 被引用次数：201 · 研究领域：Dementia and Cognitive Impairment Research、Health disparities and outcomes、Traumatic Brain Injury Research

Importance: Social determinants of health, such as income, education, housing quality, and employment, are associated with disparities in Alzheimer disease and health generally, yet these determinants are rarely incorporated within neuropathology research. Objective: To establish the feasibility of linking neuropathology data to social determinants of health exposures using neighborhood disadvantage metrics (the validated Area Deprivation Index) and to evaluate the association between neighborhood disadvantage and Alzheimer disease-related neuropathology. Design, Setting, and Participants: This cross-sectional study consisted of decedents with a known home address who donated their brains to 1 of 2 Alzheimer disease research center brain banks in California and Wisconsin between January 1, 1990, and December 31, 2016. Neither site had preexisting social metrics available for their decedents. Neuropathologic features were obtained from each site for data collected using the standardized Neuropathology Data Set form and from autopsy reports. Data were analyzed from June 7 to October 10, 2019. Exposures: Geocoded decedent addresses linked to neighborhood disadvantage as measured by the Area Deprivation Index calculated for the year of death. Main Outcomes and Measures: Presence of Alzheimer disease neuropathology. The association between neighborhood disadvantage and Alzheimer disease neuropathology was evaluated via logistic regression, adjusting for age, sex, and year of death...