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Socioeconomic Status Mediates Racial Differences Seen Using the AT(N) Framework
Meeker KL, Wisch JK, Hudson D, Coble D, Xiong C, Babulal GM, Gordon BA, Schindler SE et al.. Annals of neurology, 2020-11-07
Topic: Risk, prevention and care in population studies
Objectives African Americans are at greater risk for developing Alzheimer's disease (AD) dementia than non-Hispanic whites. In addition to biological considerations (eg, genetic influences and comorbid disorders), social and environmental factors may increase the risk of AD dementia. This paper (1) assesses neuroimaging biomarkers of amyloid (A), tau (T), and neurodegeneration (N) for potential racial differences and (2) considers mediating effects of socioeconomic status (SES) and measures of small vessel and cardiovascular disease on observed race differences. Methods Imaging measures of AT(N) (amyloid and tau positron emission tomography [PET]) structural magnetic resonance imaging (MRI), and resting state functional connectivity (rs-fc) were collected from African American (n = 131) and white (n = 685) cognitively normal participants age 45 years and older. Measures of small vessel and cardiovascular disease (white matter hyperintensities [WMHs] on MRI, blood pressure, and body mass index [BMI]) and area-based SES were included in mediation analyses. Results Compared to white participants, African American participants had greater neurodegeneration, as measured by decreased cortical volumes (Cohen's f 2 = 0.05, p Interpretation Modifiable factors, such as differences in social contexts and resources, particularly area-level SES, may contribute to observed racial differences in AD. Future studies should emphasize collection of relevant psychosocial factors in addition to the development of intentional diversity and inclusion efforts to improve the racial/ethnic and socioeconomic representativeness of AD studies. ANN NEUROL 2021;89:254-265.
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APA 7th
Meeker, K. L., Wisch, J. K., Hudson, D., Coble, D., Xiong, C., Babulal, G. M., et al. (2021). Socioeconomic Status Mediates Racial Differences Seen Using the AT(N) Framework. Annals of neurology. https://doi.org/10.1002/ana.25948
Vancouver
Meeker KL, Wisch JK, Hudson D, Coble D, Xiong C, Babulal GM, et al. Socioeconomic Status Mediates Racial Differences Seen Using the AT(N) Framework. Annals of neurology. 2021. doi:10.1002/ana.25948. PMID: 33111990.
BibTeX
@article{meeker2021-33111990,
author = {Meeker, K. L. and Wisch, J. K. and Hudson, D. and Coble, D. and Xiong, C. and Babulal, G. M. and Gordon, B. A. and Schindler, S. E. and others},
title = {{Socioeconomic Status Mediates Racial Differences Seen Using the AT(N) Framework}},
journal = {Annals of neurology},
year = {2021},
doi = {10.1002/ana.25948},
pmid = {33111990},
url = {https://doi.org/10.1002/ana.25948}
}
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Key findings
- Results Compared to white participants, African American participants had greater neurodegeneration, as measured by decreased cortical volumes (Cohen's f 2 = 0.05, p < 0.001).
Why it matters
This study examined brain imaging markers of amyloid, tau and neurodegeneration in African American and white cognitively normal adults. It found greater neurodegeneration in African American participants and suggests that area-level socioeconomic status may contribute to these differences, pointing to modifiable social factors rather than a treatment or cure.
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Study details
- Participants131
- Evidence strengthLow
How this study scored 53/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (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 | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 131 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 69 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.9 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 3 / 6 | Cited 6.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 12 other studies in this library |
| Still being cited | 2 / 4 | Cited 28 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Beau M. Ances: h-index 81 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33111990) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
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