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4- Dementia in Latin America – Social determinants of health and genetic ancestry. (Jorge J Llibre Guerra)

Published online by Cambridge University Press:  27 November 2024

Jorge J Llibre-Guerra ,
Miao Jiang ,
Isaac Acosta ,
Ana Luisa Sosa ,
Daisy Acosta ,
Ivonne Z. Jimenez-Velasquez ,
Mariella Guerra ,
Aquiles Salas ,
Ana M Rodriguez Salgado  and
Juan C Llibre-Guerra
...Show all authors
Jorge J Llibre-Guerra
Affiliation:
Department of Neurology, Washington University School of Medicine in St. Louis, MO 63110, USA.
Miao Jiang
Affiliation:
Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, 13 6900, Switzerland.
Isaac Acosta
Affiliation:
Laboratory of the Dementias, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico. National Autonomous University of Mexico, Mexico City 04510, Mexico.
Ana Luisa Sosa
Affiliation:
Laboratory of the Dementias, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico. National Autonomous University of Mexico, Mexico City 04510, Mexico.
Daisy Acosta
Affiliation:
Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine Department, Geriatric Section, Santo Domingo 1423, Dominican Republic.
Ivonne Z. Jimenez-Velasquez
Affiliation:
Internal Medicine Department, Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00931, USA.
Mariella Guerra
Affiliation:
Instituto de la Memoria Depresion y Enfermedades de Riesgo IMEDER, Lima 15073, Perú
Aquiles Salas
Affiliation:
Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas 1053, Venezuela.
Ana M Rodriguez Salgado
Affiliation:
Global Brain Health Institute, University of San Francisco California, San Francisco, CA 94117, USA.
Juan C Llibre-Guerra
Affiliation:
Department of Neurology, Hospital de Salamanca, Salamanca 37007, Spain
Nedelys Díaz Sánchez
Affiliation:
Dementia Research Unit, Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, 10400, Cuba.
Matthew Prina
Affiliation:
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX United Kingdom
Alan Renton
Affiliation:
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Emiliano Albanese
Affiliation:
Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, 13 6900, Switzerland.
Jennifer S. Yokoyama
Affiliation:
Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA. Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94158, USA.
Juan J. Llibre Rodriguez
Affiliation:
Dementia Research Unit, Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, 10400, Cuba.
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Abstract

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Objectives: Leveraging the non-monolithic 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 risk 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. The primary outcome measured was the risk of developing dementia. Multivariate linear regression models adjusted for SDoH were used in the main analysis.

Results: We observed extensive three-way (African/European/Native American) genetic ancestry variation between countries. 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 SES (p < 0.001), and higher frequency of vascular risk factors (p < 0.001). In unadjusted analysis, American individuals with predominant African ancestry exhibited a higher dementia frequency (p = 0.03) and both Native and African ancestry predominant groups showed lower cognitive performance relative to those with higher European ancestry (p < 0.001). However, 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]).

Conclusions: The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia risk in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to reduce dementia risk in these communities effectively.

Keywords

Dementiarisk factorsLatinosancestrysocial determinants of health
Type
Symposia
Information
International Psychogeriatrics , Volume 36 , Issue S1 , September 2024 , pp. 20 - 21
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of International Psychogeriatric Association