Geographic proximity, neuropathology and ADRC brain donation

Topic: Brain proteins, microglia and lab models

Abstract Background Diverse representation is a known challenge in Alzheimer’s disease research recruitment. Geographic proximity to an Alzheimer’s Disease Research Center (ADRC) may be a factor in brain donation. Whether those donating living closer to a center differ in terms of their social and biological characteristics to those living farther away is unknown. Methods In this cross sectional analysis of people donating to one of two ADRC brain banks (n=428), we examined how geographic proximity to the center, defined as living within an hour of the center, is associated with neighborhood disadvantage (Area Deprivation Index rank) as well as neuropathology at the time of death. Results Disadvantaged neighborhoods were underrepresented regardless of location. However, those living in disadvantaged neighborhoods nearest to an Alzheimer center were less likely to donate than those living farther away. With each decile increase, denoting higher levels of neighborhood disadvantage, the odds of living within an hour of a center decreased by 33% (OR=0.75, 95% CI=0.62‐0.91). Similar trends were found with Alzheimer’s disease‐related neuropathology, with a lower odds of living near a center associated with increasing Braak staging (B score) for neurofibrillary degeneration (OR=0.68, 95% CI, 0.59‐0.77), amyloid plaque presence (OR=0.73, 95% CI, 0.62‐0.87), and presence of Lewy bodies (OR=0.54, 95% CI, 0.40‐0.73). Conclusion Findings suggest donation program recruitment approaches could be optimized in disadvantaged neighborhoods, including those geographically closest to centers. Reducing Alzheimer disparities and generating the evidence needed to promote brain health for everyone requires diverse research representation, including areas near an ADRC. ADRC policy and planning efforts that facilitate research access, broaden inclusivity, and expand participation to those living in disadvantaged neighborhoods are needed.

Key findings

• Methods In this cross sectional analysis of people donating to one of two ADRC brain banks (n=428), we examined how geographic proximity to the center, defined as living within an hour of the center, is associated with neighborhood disadvantage (Area Deprivation Index rank) as well as neuropathology at the time of death.
• Results Disadvantaged neighborhoods were underrepresented regardless of location.
• Similar trends were found with Alzheimer’s disease‐related neuropathology, with a lower odds of living near a center associated with increasing Braak staging (B score) for neurofibrillary degeneration (OR=0.68, 95% CI, 0.59‐0.77), amyloid plaque presence (OR=0.73, 95% CI, 0.62‐0.87), and presence of Lewy bodies (OR=0.54, 95% CI, 0.40‐0.73).

Why it matters

This study found that people with more neighborhood disadvantage and more Alzheimer's-related brain changes at death were less likely to have lived near a brain donation center. It is about research participation and brain donation, not about treating, curing, or preventing Alzheimer's disease.

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Study details

• Participants428
• Effect sizedecreased by 33%; OR=0.75; OR=0.68
• Evidence strengthLow

Read the original

• DOI: 10.1002/alz.057512
• Original source →

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@article{powell2021-bcef8f4e,
  author  = {Powell, W. Ryan and Zuelsdorff, Megan L. and Chin, Nathaniel A. and Buckingham, William R. and Rissman, Robert A. and Bendlin, Barbara B. and Kind, Amy},
  title   = {{Geographic proximity, neuropathology and ADRC brain donation}},
  journal = {Alzheimer s \& Dementia},
  year    = {2021},
  doi     = {10.1002/alz.057512},
  url     = {https://doi.org/10.1002/alz.057512}
}

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