Socioeconomic Status, Biological Aging, and Memory in a Diverse National Sample of Older US Men and Women

Avila‐Rieger, Justina; Turney, Indira C.; Vonk, Jet M.J.; Esie, Precious; Seblova, Dominika; Weir, Vanessa; Belsky, Daniel W.; Manly, Jennifer J.

doi:10.1212/wnl.0000000000201032

Cited by 19 publications

(19 citation statements)

References 56 publications

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“…These findings are consistent with previous reports that GrimAge is more strongly associated than DPoAm with cognitive and physical function outcomes (13,23). GrimAge may be a more robust predictor of age-related health in general.…”

Section: Discussionsupporting

confidence: 93%

Epigenetic age and socioeconomic status contribute to racial disparities in cognitive and functional aging between Black and White older Americans

Yannatos,

Stites,

Boen

et al. 2023

Preprint

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Epigenetic age, a biological aging marker measured by DNA methylation, is a potential mechanism by which social factors drive disparities in age-related health. Epigenetic age gap is the residual between epigenetic age measures and chronological age. Previous studies showed associations between epigenetic age gap and age-related outcomes including cognitive capacity and performance on some functional measures, but whether epigenetic age gap contributes to disparities in these outcomes is unknown. We use data from the Health and Retirement Study to examine the role of epigenetic age gap in racial disparities in cognitive and functional outcomes and consider the role of socioeconomic status (SES). Epigenetic age measures are GrimAge or Dunedin Pace of Aging methylation (DPoAm). Cognitive outcomes are cross-sectional score and two-year change in Telephone Interview for Cognitive Status (TICS). Functional outcomes are prevalence and incidence of limitations performing Instrumental Activities of Daily Living (IADLs). We find, relative to White participants, Black participants have lower scores and greater decline in TICS, higher prevalence and incidence rates of IADL limitations, and higher epigenetic age gap. Age- and gender-adjusted analyses reveal that higher GrimAge and DPoAm gap are both associated with worse cognitive and functional outcomes and mediate 6-11% of racial disparities in cognitive outcomes and 19-39% of disparities in functional outcomes. Adjusting for SES attenuates most DPoAm associations and most mediation effects. These results support that epigenetic age gap contributes to racial disparities in cognition and functioning and may be an important mechanism linking social factors to disparities in health outcomes.

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Section: Discussionsupporting

confidence: 93%

Epigenetic age and socioeconomic status contribute to racial disparities in cognitive and functional aging between Black and White older Americans

Yannatos,

Stites,

Boen

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…SES may also be associated with healthy lifestyles, pace of biological aging, and risk of dementia. Studies have shown that lower levels of education and wealth were associated with accelerated biological aging, faster memory decline, 50 and substantially greater risk of dementia. 51 While we included education in our models, the NACC dataset has a dearth of information related to SES and therefore, SES differences could not be accounted for in our study.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D supplementation and incident dementia: Effects of sex, APOE, and baseline cognitive status

Ghahremani

Smith

Chen

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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Introduction Despite the association of vitamin D deficiency with incident dementia, the role of supplementation is unclear. We prospectively explored associations between vitamin D supplementation and incident dementia in 12,388 dementia‐free persons from the National Alzheimer's Coordinating Center. Methods Baseline exposure to vitamin D was considered D+; no exposure prior to dementia onset was considered D−. Kaplan–Meier curves compared dementia‐free survival between groups. Cox models assessed dementia incidence rates across groups, adjusted for age, sex, education, race, cognitive diagnosis, depression, and apolipoprotein E ( APOE ) ε4. Sensitivity analyses examined incidence rates for each vitamin D formulation. Potential interactions between exposure and model covariates were explored. Results Across all formulations, vitamin D exposure was associated with significantly longer dementia‐free survival and lower dementia incidence rate than no exposure (hazard ratio = 0.60, 95% confidence interval: 0.55–0.65). The effect of vitamin D on incidence rate differed significantly across the strata of sex, cognitive status, and APOE ε4 status. Discussion Vitamin D may be a potential agent for dementia prevention. Highlights In a prospective cohort study, we assessed effects of Vitamin D on dementia incidence in 12,388 participants from the National Alzheimer's Coordinating Center dataset. Vitamin D exposure was associated with 40% lower dementia incidence versus no exposure. Vitamin D effects were significantly greater in females versus males and in normal cognition versus mild cognitive impairment. Vitamin D effects were significantly greater in apolipoprotein E ε4 non‐carriers versus carriers. Vitamin D has potential for dementia prevention, especially in the high‐risk strata.

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“…For example, gendered racism 94,95 —the simultaneous experience of racism and sexism—was associated with a higher number of cognitive complaints in US women racialized as Black 96 . Another US‐based study revealed meaningful differences at the intersection of racism and sexism in biological aging, an emerging risk factor for AD/ADRD 97 . A large‐scale study in the UK saw significant intersectional effects of gender, socioeconomic status, and racialized group on biological markers of aging.…”

Section: Results: a Globalized Macrosystemmentioning

confidence: 99%

“…96 Another US-based study revealed meaningful differences at the intersection of racism and sexism in biological aging, an emerging risk factor for AD/ADRD. 97 A large-scale study in the UK saw significant intersectional effects of gender, socioeconomic status, and racialized group on biological markers of aging. This study reported that groups racialized as Black and other racialized and minoritized cisgender men with fewer educational opportunities had higher systolic blood pressure compared to other groups.…”

Section: Intersectionalitymentioning

confidence: 99%

The structural and social determinants of Alzheimer's disease related dementias

Adkins‐Jackson

George

Besser

et al. 2023

Alzheimer's & Dementia

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Introduction The projected growth of Alzheimer's disease (AD) and AD‐related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD. Methods In this review, we employ Bronfenbrenner's ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes. Results Bronfenbrenner defined the “macrosystem” as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper. Discussion Under Bronfenbrenner's macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research. Highlights Ecological systems theory links structural/social determinants to AD/ADRD. Structural/social determinants accrue and interact over the life course to impact AD/ADRD. Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws). Most macro‐level determinants have been understudied in the AD/ADRD literature.

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Socioeconomic Status, Biological Aging, and Memory in a Diverse National Sample of Older US Men and Women

Cited by 19 publications

References 56 publications

Epigenetic age and socioeconomic status contribute to racial disparities in cognitive and functional aging between Black and White older Americans

Epigenetic age and socioeconomic status contribute to racial disparities in cognitive and functional aging between Black and White older Americans

Vitamin D supplementation and incident dementia: Effects of sex, APOE, and baseline cognitive status

The structural and social determinants of Alzheimer's disease related dementias

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