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Association between the social exposome and vascular brain injury in brain bank donors
Sarah A. Keller, W. Ryan Powell, William R. Buckingham, Amanda DeWitt, Barbara B. Bendlin, Amy Kind. Alzheimer s & Dementia, 2024-12-01
Topic: Brain proteins, microglia and lab models
Abstract Background The social exposome, all social‐environmental exposures accumulated over the life course, could partially explain Alzheimer’s disease and other dementias (ADRD) disparities. Measurement and linkage of life course social exposome metrics to biological samples may inform opportunities for intervention. While there is increasing emphasis on the life course social exposome in ADRD research, there is little consensus on its measurement. Vascular brain injury (VBI) is a measure of changes in the cerebral blood vessels associated with increased risk of ADRD, but the extent to which social exposures are associated with VBI is unknown. Method We evaluated the association between life course social exposome measures and the VBI burden acrosstwo Alzheimer’s Disease Research Center (ADRC) brain banks. Geocoded life course donor addresses were linked to time‐concordant national Area Deprivation Index (ADI) rankings, with greater ADI denoting greater county‐level disadvantage. Life course social exposome was examined separately as 1, a cumulative measure of the number of years spent above the population median life course ADI, and 2, the change in ADI from youth to adulthood. The outcome was the presence of any of four VBI indicators: infarcts, microinfarcts, hemorrhages, and white matter rarefaction. The association of life course social exposome to VBI burden was evaluated via logistic regression adjusting for sex and age at death. Result This sample contained 740 donors from two brain banks. The population median ADI was 7.08 (IQR, 5.5) and the mean number of years spent above this threshold was 19.95 (SD, 20.89). More years living in a county above the population median was associated with increased VBI burden (OR, 1.04, 95% CI, 1.03‐1.05). A median ADI which increased (OR, 3.67, 95% CI, 3.65‐3.70) or remained stably high between youth and adulthood (OR, 3.08, 95% CI, 3.01‐3.14) resulted in increased odds of VBI burden. Conclusion This study shows promise for clarifying the relationship between the social exposome and ADRD brain pathology post‐mortem. We found associations between higher life course ADI (greater disadvantage) and VBI burden. Identifying dosages and timing of life course exposures critical for development of VBI allows for future intervention to reduce disparities in ADRD.
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APA 7th
Keller, S. A., Powell, W. R., Buckingham, W. R., DeWitt, A., Bendlin, B. B., & Kind, A. (2024). Association between the social exposome and vascular brain injury in brain bank donors. Alzheimer s & Dementia. https://doi.org/10.1002/alz.090924
Vancouver
Keller SA, Powell WR, Buckingham WR, DeWitt A, Bendlin BB, Kind A. Association between the social exposome and vascular brain injury in brain bank donors. Alzheimer s & Dementia. 2024. doi:10.1002/alz.090924.
BibTeX
@article{keller2024-4d83ba32,
author = {Keller, Sarah A. and Powell, W. Ryan and Buckingham, William R. and DeWitt, Amanda and Bendlin, Barbara B. and Kind, Amy},
title = {{Association between the social exposome and vascular brain injury in brain bank donors}},
journal = {Alzheimer s \& Dementia},
year = {2024},
doi = {10.1002/alz.090924},
url = {https://doi.org/10.1002/alz.090924}
}
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Key findings
- Vascular brain injury (VBI) is a measure of changes in the cerebral blood vessels associated with increased risk of ADRD, but the extent to which social exposures are associated with VBI is unknown.
- Result This sample contained 740 donors from two brain banks.
- More years living in a county above the population median was associated with increased VBI burden (OR, 1.04, 95% CI, 1.03‐1.05).
- We found associations between higher life course ADI (greater disadvantage) and VBI burden.
Why it matters
Among 740 brain bank donors, more years living in a more disadvantaged county was linked to a greater burden of vascular brain injury. This shows an association between life course social conditions and blood vessel changes in the brain but does not test any treatment or prevention.
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Study details
- Evidence strengthLow
How this study scored 31/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Amy Kind: h-index 47 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Wisconsin–Madison: institution h-index 1,518 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 31 / 100 | — |
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