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Lookup NU author(s): Professor Matthew Prina
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
INTRODUCTION: Leveraging the nonmonolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia prevalence in Latin American populations. METHODS: Community-dwelling participants aged 65 and older (N = 3808) from Cuba, Dominican Republic, Mexico, and Peru completed the 10/66 protocol assessments. Dementia was diagnosed using the cross-culturally validated 10/66 algorithm. Multivariate linear regression models adjusted for SDoH were used in the main analysis. This study used cross-sectional data from the 1066 population-based study. RESULTS: Individuals with higher proportions of Native American (>70%) and African American (>70%) ancestry were more likely to exhibit factors contributing to worse SDoH, such as lower educational levels (p < 0.001), lower socioeconomic status (p < 0.001), and higher frequency of vascular risk factors (p < 0.001). After adjusting for measures of SDoH, there was no association between ancestry proportion and dementia probability, and ancestry proportions no longer significantly accounted for the variance in cognitive performance (African predominant p = 0.31 [-0.19, 0.59] and Native predominant p = 0.74 [-0.24, 0.33]). DISCUSSION: The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia prevalence in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to effectively reduce dementia risk in these communities. Highlights: Countries in Latin America express a large variability in social determinants of health and levels of admixture. After adjustment for downstream societal factors linked to SDoH, genetic ancestry shows no link to dementia. Population ancestry profiles alone do not influence cognitive performance. SDoH are key drivers of racial disparities in dementia and cognitive performance.
Author(s): Llibre-Guerra JJ, Jiang M, Acosta I, Sosa AL, Acosta D, Jimenez-Velasquez IZ, Guerra M, Salas A, Rodriguez Salgado AM, Libre-Guerra JC, Sanchez ND, Prina M, Renton A, Albanese E, Yokoyama JS, Libre Rodriguez JJ
Publication type: Article
Publication status: Published
Journal: Alzheimer's & Dementia
Year: 2024
Volume: 20
Issue: 7
Pages: 4828-4840
Print publication date: 15/07/2024
Online publication date: 05/06/2024
Acceptance date: 09/05/2024
Date deposited: 21/08/2024
ISSN (print): 1552-5260
ISSN (electronic): 1552-5279
Publisher: John Wiley & Sons, Inc.
URL: https://doi.org/10.1002/alz.14041
DOI: 10.1002/alz.14041
ePrints DOI: 10.57711/566v-ra38
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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