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Exploring Neighborhood Level Socioeconomic Status and Volumetric MRI Results in Patients with Memory Impairment
Hannah M Stamos, Mia Achitoov, Nadia Zia, Hessam Sadatsafavi, Bahar Niknejad, Hamid Reza Okhravi. Alzheimer s & Dementia, 2024-12-01
Topic: Risk, prevention and care in population studies
Abstract Background This study addresses the impact of neighborhood‐level socioeconomic disadvantage, as measured by the Area Deprivation Index (ADI), on individuals with mild cognitive impairment and dementia. Our primary outcome aimed to explore associations between ADI and hippocampal volume in cognitively impaired individuals from a comprehensive memory center. Methods We conducted a retrospective, cross‐sectional analysis of patients over 50 from Virginia and North Carolina, with visits between January 1st, 2014, and July 1st, 2022. Normative percentile of hippocampal volume, total hippocampal occupancy scores (HOC), superior lateral ventricular volume, and inferior lateral ventricular volume of patients living in census block groups at the top and bottom 20th ADI percentiles were compared. We fitted a linear regression model on propensity‐matched data in the two ADI groups, with multiple covariates. We performed g‐computation in the matched sample and included the interaction of ADI category with covariates and the matching weights in the estimation. Results A total of 310 patients were included in the analysis, with 8% of the subjects in the high‐ADI category. The actual sample size slightly varied for each outcome after excluding missing records, thus full matching was utilized. The estimated average treatment effect for high versus low ADI groups only reached statistical significance for hippocampal volume with the difference of 13.9% (SE = 5.83, p = 0.01). The difference of 0.7% (SE = 2.11, p = 0.75) for HOC, 0.5% (SE = 4.13, p = 0.90) for superior lateral ventricular volume, and ‐0.2% (SE = 7.18, p = 0.90) for inferior lateral ventricular volume were not statistically significant. Conclusions Contrary to expectations, high versus low ADI groups only showed a difference in hippocampal volume, but in the reverse direction. This finding may suggest global effects of the ADI on the brain health, rather than focal effects on hippocampus. Due to the limited size of our sample in the top 20th percentile, further validation of this discovery is necessary through studies employing larger sample sizes.
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APA 7th
Stamos, H. M., Achitoov, M., Zia, N., Sadatsafavi, H., Niknejad, B., & Okhravi, H. R. (2024). Exploring Neighborhood Level Socioeconomic Status and Volumetric MRI Results in Patients with Memory Impairment. Alzheimer s & Dementia. https://doi.org/10.1002/alz.089348
Vancouver
Stamos HM, Achitoov M, Zia N, Sadatsafavi H, Niknejad B, Okhravi HR. Exploring Neighborhood Level Socioeconomic Status and Volumetric MRI Results in Patients with Memory Impairment. Alzheimer s & Dementia. 2024. doi:10.1002/alz.089348.
BibTeX
@article{stamos2024-59cad8f7,
author = {Stamos, Hannah M and Achitoov, Mia and Zia, Nadia and Sadatsafavi, Hessam and Niknejad, Bahar and Okhravi, Hamid Reza},
title = {{Exploring Neighborhood Level Socioeconomic Status and Volumetric MRI Results in Patients with Memory Impairment}},
journal = {Alzheimer s \& Dementia},
year = {2024},
doi = {10.1002/alz.089348},
url = {https://doi.org/10.1002/alz.089348}
}
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Key findings
- Results A total of 310 patients were included in the analysis, with 8% of the subjects in the high‐ADI category.
- The estimated average treatment effect for high versus low ADI groups only reached statistical significance for hippocampal volume with the difference of 13.9% (SE = 5.83, p = 0.01).
- The difference of 0.7% (SE = 2.11, p = 0.75) for HOC, 0.5% (SE = 4.13, p = 0.90) for superior lateral ventricular volume, and ‐0.2% (SE = 7.18, p = 0.90) for inferior lateral ventricular volume were not statistically significant.
- Conclusions Contrary to expectations, high versus low ADI groups only showed a difference in hippocampal volume, but in the reverse direction.
Why it matters
Among 310 patients with memory impairment, those living in the most disadvantaged neighborhoods had a 13.9% difference in hippocampal volume compared to those in the least disadvantaged areas. Other brain measures did not differ significantly, and the study cannot show that neighborhood conditions cause these brain changes.
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Study details
- Participants310
- Effect size13.9%; 0.7%; 0.5%
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design 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 | 2 / 4 | 310 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| 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 | 1 / 4 | Last-listed author Hamid Reza Okhravi: h-index 12 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 38 / 100 | — |
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