Abstract P2162: Contributions of life-course socioeconomic position to later-life MRI measures of vascular brain injury: Results from SOL-INCA-MRI

Abstract

Introduction: Cardiovascular and brain health are closely related. Increasing research has shown that cumulative exposure to low socioeconomic position (SEP) over the life-course increases the burden of poor cardiovascular and brain health. However, the influence of life-course SEP in later-life measures of vascular brain injury has rarely been evaluated Hypothesis: Life-course SEP is associated with white matter hyperintensity volume-WMHV and brain infarcts, two magnetic resonance imaging-MRI derived measures of vascular brain injury Methods: We used data from adults aged 50-85 years (n=2400) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL-INCA-MRI), a population-based cohort study in the U.S. Participants' self-reports of their parental educational attainment was used as a proxy for childhood SEP (<high school-HS and ≥HS). Indexes combining participant’s education, household income, employment, and house ownership were used as proxy for adult SEP (lower and higher SEP) at visit 1 (2008-2011) and visit 2 (2014-2017). Using childhood and adult SEP at visit 1, we classified participants into four socioeconomic mobility categories (stable low or high SEP, upward or downward mobility). WMHV and brain infarcts were quantified (2018-2022) using 3T MRI scans. We used inverse probability weighting and marginal structural models accounting for the complex sampling design, demographic, behavioral, and clinical covariates to quantify the association between life-course SEP and log-WMHV and brain infarcts (Yes or No) Results: Hispanic/Latinos with higher adult SEP at visit 2 had -0.25 (-0.46, -0.04) log-WMHV relative to those with lower SEP. Similarly, adults with upward socioeconomic mobility had -0.24 (-0.47, -0.02) log-WMHV relative to those with stable low SEP. We did not find associations between childhood or adult SEP at visit 1, downward or stable high SEP with log-WMHV. No associations were found between measures of life-course SEP and brain infarcts, except for upward socioeconomic mobility (OR: 0.52 [0.27, 1.00]) Conclusion: This study shows that, among U.S. Hispanic/Latinos, higher adult SEP at visit 2 and upward socioeconomic mobility have a positive influence on WMHV or brain infarcts, highlighting the benefits of an advantageous life-course SEP on measures of vascular brain injury. This study also suggests that vascular brain injury is mostly influenced by stressors in later adulthood rather than in early life