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Cited by 47Dementia and Cognitive Impairment ResearchHealth disparities and outcomesAlzheimer's disease research and treatments

Socioeconomic Deprivation, Genetic Risk, and Incident Dementia

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Klee, Matthias, Leist, Anja K., Veldsman, Michele, Ranson, Janice M., Llewellyn, David J.·2023·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2023.01.012PMC PMC10126314
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Abstract

INTRODUCTION: Socioeconomic factors and genetic predisposition are established risk factors for dementia. It remains unclear whether associations of socioeconomic deprivation with dementia incidence are modified by genetic risk. METHODS: Participants in the UK Biobank aged ≥60 years and of European ancestry without dementia at baseline (2006-2010) were eligible for the analysis, with the main exposures area-level deprivation based on the Townsend Deprivation Index and individual-level socioeconomic deprivation based on car and home ownership, housing type and income, and polygenic risk of dementia. Dementia was ascertained in hospital and death records. Analysis was conducted in 2021. RESULTS: In this cohort study, 196,368 participants (mean [SD] age=64.1 [2.9] years, 52.7% female) were followed up for 1,545,316 person-years (median [IQR] follow-up=8.0 [7.4-8.6] years). In high genetic risk and high area-level deprivation, 1.71% (95% CI=1.44, 2.01) developed dementia compared with 0.56% (95% CI=0.48, 0.65) in low genetic risk and low-to-moderate area-level deprivation (hazard ratio=2.31; 95% CI=1.84, 2.91). In high genetic risk and high individual-level deprivation, 1.78% (95% CI=1.50, 2.09) developed dementia compared with 0.31% (95% CI=0.20, 0.45) in low genetic risk and low individual-level deprivation (hazard ratio=4.06; 95% CI=2.63, 6.26). There was no significant interaction between genetic risk and area-level (p=0.77) or individual-level (p=0.07) deprivation. An imaging substudy including 11,083 participants found a greater burden of white matter hyperintensities associated with higher socioeconomic deprivation. CONCLUSIONS: Individual-level and area-level socioeconomic deprivation were associated with increased dementia risk. Dementia prevention interventions may be particularly effective if targeted to households and areas with fewer socioeconomic resources, regardless of genetic vulnerability.

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  • Covariates were selected based on their known associations with Alzheimer Disease in the UK Biobank cohort.

    “Covariates were selected based on their known associations with Alzheimer Disease in the UKB cohort.”

    From TET2-mutant myeloid cells mitigate Alzheimer’s disease progression via CNS infiltration and enhanced phagocytosis in mice (2025) · cites this paper as [78]

    The Methods > Measures section lists covariates used in models of the UK Biobank cohort. It does not say they were selected because of known associations with Alzheimer disease; the study’s modeled outcome was incident all-cause dementia. Page numbers are not available in our copy. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Klee, M., Leist, A. K., Veldsman, M., Ranson, J. M., & Llewellyn, D. J.
Affiliations
  • University of Luxembourg (LU)
  • University of Oxford (GB)
  • University of Exeter (GB)
Corresponding author
Leist, Anja K.
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2023-05
Volume
64
Issue
5
Pages
621-630
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2023.01.012
PMC
PMC10126314
OpenAlex
W4323317127
Cited by
47
References
8
Citations by year
2026: 11 · 2025: 20 · 2024: 13 · 2023: 2 · 2014: 1
FWCI
9.37
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Preventive Medicine (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • Open Repository and Bibliography (University of Luxembourg) (submittedVersion, other-oa)
Funders
  • Wellcome Trust
  • National Institute for Health and Care Research
  • National Institute on Aging (RF1AG055654)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
dementia, socioeconomic deprivation, genetic risk, polygenic risk, area deprivation, Townsend deprivation index, white matter hyperintensities, dementia incidence, dementia prevention
MeSH terms
Dementia, Female, Humans, Income, Male, Risk Factors, Socioeconomic Factors, Cohort Studies

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