Socioeconomic Status Mediates Racial Differences Seen Using the AT(N) Framework

• Published in: Annals of neurology 2021-02, Vol.89 (2), p.254-265
• Main Authors: Meeker, Karin L., Wisch, Julie K., Hudson, Darrell, Coble, Dean, Xiong, Chengjie, Babulal, Ganesh M., Gordon, Brian A., Schindler, Suzanne E., Cruchaga, Carlos, Flores, Shaney, Dincer, Aylin, Benzinger, Tammie L., Morris, John C., Ances, Beau M.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - ethnology; Alzheimer Disease - metabolism; Alzheimer Disease - physiopathology; Alzheimer's disease; Amyloid beta-Peptides - metabolism; Aniline Compounds; Biomarkers; Black or African American; Blood pressure; Blood vessels; Body mass; Body mass index; Body size; Brain - diagnostic imaging; Brain - metabolism; Brain - physiopathology; Carbolines; Cardiovascular disease; Cardiovascular diseases; Cerebral Small Vessel Diseases - diagnostic imaging; Dementia; Dementia disorders; Environmental factors; Ethylene Glycols; Female; Functional magnetic resonance imaging; Functional Neuroimaging; Health risks; Humans; Magnetic Resonance Imaging; Male; Mediation Analysis; Medical imaging; Middle Aged; Minority & ethnic groups; Neural networks; Neurodegeneration; Neurodegenerative diseases; Neuroimaging; Positron emission; Positron emission tomography; Race; Racial differences; Radiopharmaceuticals; Social Class; Socioeconomic factors; Socioeconomic status; Socioeconomics; Substantia alba; Tau protein; tau Proteins - metabolism; Thiazoles; Tomography; White
• ISSN: 0364-5134; 1531-8249
• DOI: 10.1002/ana.25948

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 f2 = 0.05, p