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Grief and Economic Stressors by Sex, Gender, and Education: Associations With Alzheimer Disease-Related Outcomes
Palpatzis E, Akinci M, Garcia-Prat M, Blennow K, Zetterberg H, Quijano-Rubio C, Kollmorgen G, Wild N et al.. Neurology, 2025-03-31
Topic: Amyloid, tau and blood-test diagnosis
Background and objectives The prevalence and impact of stressful life events (SLEs) on age-related and Alzheimer disease (AD)-related pathways may depend on social determinants including gender and education. We investigated whether specific SLEs are associated with AD pathology and neurodegeneration and how these associations differ by gender and education. Methods This cross-sectional study included cognitively unimpaired participants, most with a family history of sporadic AD, from the ALzheimer's and FAmilies (ALFA) cohort, based in Barcelona, Spain.
Key findings
- We investigated whether specific SLEs are associated with AD pathology and neurodegeneration and how these associations differ by gender and education.
- Methods This cross-sectional study included cognitively unimpaired participants, most with a family history of sporadic AD, from the ALzheimer's and FAmilies (ALFA) cohort, based in Barcelona, Spain.
- Participants had available assessments on occurrence and type of lifetime SLEs and lumbar puncture and/or structural MRI.
- We performed multiple regression analyses to examine the associations of specific SLE type with (1) AD pathologies (CSF phosphorylated tau 181 [p-tau181] and β-amyloid [Aβ] 42/40) and (2) neurodegeneration markers (CSF neurogranin and GM volumes voxel-wise) including interaction and stratification analyses by gender (women/men) and education.
Why it matters
This cross-sectional study asked whether stressful life events such as grief and financial strain relate to Alzheimer's pathology and brain changes, and whether this differs by gender and education. It identifies possible social risk factors but does not show that relieving stress prevents or treats the disease.
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Study details
- Study designcross-sectional
- Evidence strengthModerate
How this study scored 52/100
Published in a leading specialty journal, and it is a snapshot of people at one point in time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 50 of the 96 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.8× 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 | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 17 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40163795) |
| Free to read | 2 / 2 | Free to read |
| Points | 50 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 50 of the 96 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Palpatzis, E., Akinci, M., Garcia-Prat, M., Blennow, K., Zetterberg, H., Quijano-Rubio, C., et al. (2025). Grief and Economic Stressors by Sex, Gender, and Education: Associations With Alzheimer Disease-Related Outcomes. Neurology. https://doi.org/10.1212/wnl.0000000000213377
Vancouver
Palpatzis E, Akinci M, Garcia-Prat M, Blennow K, Zetterberg H, Quijano-Rubio C, et al. Grief and Economic Stressors by Sex, Gender, and Education: Associations With Alzheimer Disease-Related Outcomes. Neurology. 2025. doi:10.1212/wnl.0000000000213377. PMID: 40163795.
BibTeX
@article{palpatzis2025-40163795,
author = {Palpatzis, E. and Akinci, M. and Garcia-Prat, M. and Blennow, K. and Zetterberg, H. and Quijano-Rubio, C. and Kollmorgen, G. and Wild, N. and others},
title = {{Grief and Economic Stressors by Sex, Gender, and Education: Associations With Alzheimer Disease-Related Outcomes}},
journal = {Neurology},
year = {2025},
doi = {10.1212/wnl.0000000000213377},
pmid = {40163795},
url = {https://doi.org/10.1212/wnl.0000000000213377}
}
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