Disadvantaged neighbourhoods, modifiable risk factors, and cerebral small vessel disease in healthy midlife adults: the PREVENT Dementia study
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| Publicat a: | Alzheimer's & Dementia vol. 21 (Dec 1, 2025) |
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| Autor principal: | |
| Altres autors: | , , , , , , , , , , , , , , , , , , , |
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John Wiley & Sons, Inc.
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| 001 | 3286005979 | ||
| 003 | UK-CbPIL | ||
| 022 | |a 1552-5260 | ||
| 022 | |a 1552-5279 | ||
| 024 | 7 | |a 10.1002/alz70860_106158 |2 doi | |
| 035 | |a 3286005979 | ||
| 045 | 0 | |b d20251201 | |
| 100 | 1 | |a Low, Audrey |u Mayo Clinic, Rochester, MN, USA, | |
| 245 | 1 | |a Disadvantaged neighbourhoods, modifiable risk factors, and cerebral small vessel disease in healthy midlife adults: the PREVENT Dementia study | |
| 260 | |b John Wiley & Sons, Inc. |c Dec 1, 2025 | ||
| 513 | |a Journal Article | ||
| 520 | 3 | |a Background Individuals living in socioeconomically disadvantaged areas are disproportionately affected by dementia. However, the pathway leading from neighbourhood deprivation to cognitive symptoms is not well understood. To test our hypothesis that this relationship is associated with cerebral small vessel disease (SVD), we examined (1) whether neighbourhood deprivation related to midlife SVD burden and cognition, and (2) whether these links can be explained by modifiable lifestyle risk factors. Method In this multi‐centre cross‐sectional study, 514 cognitively healthy midlife participants aged 40‐59 years (median 52 years, 64.6% female) underwent clinical assessment and 3T MRI. Postcode data were used to obtain national indices of neighbourhood deprivation. To quantify SVD, we assessed white matter hyperintensities (WMH), perivascular spaces, cerebral microbleeds, and lacunes. Cognition was assessed using the Computerized Assessment of Information Processing (COGNITO) battery. Lifestyle risk factors were evaluated based on clinical data. Using multivariate statistics like structural equation modelling (SEM) and canonical correlation analysis (CCA), we examined associations between these constructs both globally and at the item‐level (i.e., distinction between domains of cognition/deprivation), to shed light on specific domains that could inform targeted prevention strategies. Result Neighbourhood deprivation related to greater prevalence of lifestyle risk factors (r = 0.36, p < .001), greater SVD burden (b=0.18, p = .01; Figure 1), and greater cognitive impairment (r = 0.36, p < .001), independent of educational attainment, sex, and age. These links with neighbourhood deprivation were largely driven by lifestyle factors relating to vascular health (sleep, physical activity, obesity, hypertension) (Figure 2), and cognitive deficits consistent with SVD (processing speed, visuospatial) (Figure 3). Residents of deprived neighbourhoods displayed greater prevalence of lifestyle risk factors, except alcohol consumption. Lower cognitive scores were most closely associated with deprivation domains of Crime and Living Environment (Figure 3). The DEPRIVATION→SVD path was mediated by lifestyle risk factors (z=2.57, p = .010), and the DEPRIVATION→COGNITION path was mediated by SVD (z=‐2.14, p = .032) (global SVD & hypertensive subtype, but not CAA‐SVD). Conclusion The pathway linking neighbourhood disadvantage to cognitive impairment at midlife is influenced by vascular risk factors and cerebrovascular burden. Tailored strategies could promote resilience against dementia by promoting health behaviours aligned with the community's unique needs. | |
| 653 | |a Physical fitness | ||
| 653 | |a Alcohol related crime | ||
| 653 | |a Deprivation | ||
| 653 | |a Correlation analysis | ||
| 653 | |a Dementia | ||
| 653 | |a Politics | ||
| 653 | |a Magnetic resonance imaging | ||
| 653 | |a Health status | ||
| 653 | |a Hypertension | ||
| 653 | |a Cognition | ||
| 653 | |a Middle age | ||
| 653 | |a Cognitive ability | ||
| 653 | |a Lifestyles | ||
| 653 | |a Educational attainment | ||
| 653 | |a Cognitive impairment | ||
| 653 | |a Resilience | ||
| 653 | |a Cognition & reasoning | ||
| 653 | |a Disadvantaged | ||
| 653 | |a Information processing | ||
| 653 | |a Prevention | ||
| 653 | |a Alcohol use | ||
| 653 | |a Drinking behavior | ||
| 653 | |a Health behavior | ||
| 653 | |a Discriminant analysis | ||
| 653 | |a Neighborhoods | ||
| 653 | |a Clinical assessment | ||
| 653 | |a Data processing | ||
| 653 | |a Deprived areas | ||
| 653 | |a Risk factors | ||
| 653 | |a Health promotion | ||
| 653 | |a Obesity | ||
| 653 | |a Risk assessment | ||
| 653 | |a Structural equation modeling | ||
| 653 | |a Crime | ||
| 653 | |a Health education | ||
| 653 | |a Attainment | ||
| 653 | |a Adults | ||
| 653 | |a Disease | ||
| 653 | |a Computerization | ||
| 653 | |a Statistics | ||
| 700 | 1 | |a Ntailianis, Georgios |u Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom, | |
| 700 | 1 | |a Tsvetanov, Kamen A |u Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Prats‐Sedano, Maria A |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a McKiernan, Elizabeth Frances |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Carter, Stephen F |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Stefaniak, James D |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Nannoni, Stefania |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a McKeever, Anna |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Su, Li |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Dounavi, Maria‐Eleni |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 700 | 1 | |a Muniz‐Terrera, Graciela |u Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom, | |
| 700 | 1 | |a Bridgeman, Katie |u Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom, | |
| 700 | 1 | |a Gregory, Sarah |u Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom, | |
| 700 | 1 | |a Ritchie, Karen |u Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom, | |
| 700 | 1 | |a Lawlor, Brian A |u Trinity College Dublin, Dublin, Ireland, | |
| 700 | 1 | |a Naci, Lorina |u Trinity College Dublin, Dublin, Ireland, | |
| 700 | 1 | |a Malhotra, Paresh |u Imperial College London, London, United Kingdom, | |
| 700 | 1 | |a Koychev, Ivan |u University of Oxford, Oxford, United Kingdom, | |
| 700 | 1 | |a Ritchie, Craig |u Scottish Brain Sciences, Edinburgh, Scotland, United Kingdom, | |
| 700 | 1 | |a O'Brien, John T |u University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, | |
| 773 | 0 | |t Alzheimer's & Dementia |g vol. 21 (Dec 1, 2025) | |
| 786 | 0 | |d ProQuest |t Consumer Health Database | |
| 856 | 4 | 1 | |3 Citation/Abstract |u https://www.proquest.com/docview/3286005979/abstract/embedded/6A8EOT78XXH2IG52?source=fedsrch |
| 856 | 4 | 0 | |3 Full Text |u https://www.proquest.com/docview/3286005979/fulltext/embedded/6A8EOT78XXH2IG52?source=fedsrch |
| 856 | 4 | 0 | |3 Full Text - PDF |u https://www.proquest.com/docview/3286005979/fulltextPDF/embedded/6A8EOT78XXH2IG52?source=fedsrch |