Social exposome and brain health outcomes of dementia across Latin America
Abstract
Abstract A multidimensional social exposome (MSE)—the combined lifespan measures of education, food insecurity, financial status, access to healthcare, childhood experiences, and more—may shape dementia risk and brain health over the lifespan, particularly in underserved regions like Latin America. However, the MSE effects on brain health and dementia are unknown. We evaluated 2211 individuals (controls, Alzheimer’s disease, and frontotemporal lobar degeneration) from a non-representative sample across six Latin American countries. Adverse exposomes associate with poorer cognition in healthy aging. In dementia, more complex exposomes correlate with lower cognitive and functional performance, higher neuropsychiatric symptoms, and brain structural and connectivity alterations in frontal-temporal-limbic and cerebellar regions. Food insecurity, financial resources, subjective socioeconomic status, and access to healthcare emerge as critical predictors. Cumulative exposome measures surpass isolated factors in predicting clinical-cognitive profiles. Multiple sensitivity analyses confirm our results. Findings highlight the need for personalized approaches integrating MSE across the lifespan, emphasizing prevention and interventions targeting social disparities.
Article Details
Authors (36)
Joaquín Migeot
Stefanie D. Pina-Escudero
Hernan Hernandez
Raul Gonzalez-Gomez
Agustina Legaz
Sol Fittipaldi
Elisa de Paula França Resende
Claudia Duran-Aniotz
José Alberto Ávila-Funes
Maria I. Behrens
Martin A. Bruno
Juan Felipe Cardona
Nilton Custodio
Adolfo M. García
Maria E. Godoy
Kun Hu
Serggio Lanata
Brian Lawlor
Francisco Lopera
Marcelo Adrian Maito
Diana L. Matallana
Bruce Miller
J. Jaime Miranda
Maira Okada de Oliveira
Pablo Reyes
Hernando Santamaria-Garcia
Andrea Slachevsky
Ana L. Sosa
Leonel T. Takada
Jacqueline M. Torres
Sven Vanneste
Victor Valcour
Olivia Wen
Jennifer S. Yokoyama
Katherine L. Possin
Agustín Ibañez