Social Determinants of Health in Alzheimer’s Disease Patients from Peru, Nested Study From the Peruvian Alzheimer Disease Initiative (PeADI)
Maryenela Illanes-Manrique1, Pilar Giron-Davila2, Midiam Silva-Bullon1, Larry Adams5, Sheila Castro-Suarez3, Julia Rios-Pinto8, Pedro Mena5, Farid Rajabli5, Katalina McInerney6, Ivan Cornejo-Herrera9, Michael L. Cuccaro5, Edward Ochoa-Valle10, Jeffery Vance5, Angel Medina-Colque11, Koni Mejia-Rojas12, Elison Sarapura-Castro13, Sergio Lannata14, Azizi Seixas15, Margaret Pericak-Vance7, Mario Cornejo Olivas4
1Neurogenetics Working Group, Universidad Cientifica del Sur, 2Neurogenetics Research Center, 3CBI en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurologicas, 4Instituto Nacional de Ciencias Neurologicas, 5John P. Hussman Institute for Human Genomics, 6Department of Neurology, University of Miami Miller School of Medicine, 7University of Miami Miller School of Medicine, 8Universidad Peruana Los Andes, 9Hospital Hipolito de Tacna, 10Hospital Regional de Cusco, 11Direccion Regional de Salud de Puno, 12Centro Médico EDMECON Educación Médica Continua, 13Neurogenetics Research Center, Instituto Nacional De Ciencias Neurologicas, 14Memory and Aging Center, University of California San Francisco, 15Department of Informatics and Health Data Science, University of Miami
Objective:
We aim to identify the main SDOH associated with Alzheimer’s disease (AD) by comparing AD cases to cognitively unimpaired (CU) individuals in the PeADI study.
Background:
Social, behavioral and environmental determinants of health (SDOH) such as access to and quality of education and healthcare, and socioeconomic factors influence health outcomes, including dementia.
Design/Methods:
The Social Determinants of Brain Health Questionnaire (SDOBH-Q) underwent expert review by local and international neurologists/psychiatrists and local linguistic adaptation. We administer the revised questionnaire to over 100 AD cases and 100 CU individuals from an ongoing genetic study of AD (PeADI) in Peru. This includes participants from three predominantly rural regions in the Andean highlands (Huancayo, Cusco, Puno) and three coastal urban regions (Lima, Callao, Tacna). The association between identified SDOH and AD status will be analyzed using multivariable regressions, adjusted for age, gender, and population substructure.
Results:
The revised SDOBH-Q questionnaire consists of 15 sections and 79 questions. The pilot assessment was completed by 28 CU volunteers: 17 from Lima and 11 from Huancayo. Preliminary data from the first 60 participants have been collected across regions from both the coast and the Andean highlands of Peru, showing differences between AD and CU regarding neighborhood, education, healthcare access and economic conditions.
Conclusions:
SDOH components including neighborhood, education, healthcare access, economic conditions, and environmental factors, may increase the risk of AD in older Peruvian individuals. Gaining a deeper understanding of how genetic and environmental factors interact in the context of AD and related dementias across diverse populations, including Latinos, is critical for future research.
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