Social Inequalities and the Onset of Alzheimer's Pathology: The Role of Race/Ethnicity, Cognitive Reserve, and Occupational Complexity

Abstract Alzheimer's disease and related dementias (ADRD) are the fifth most common cause of death, and the only major cause of death for which there is no prevention or cure. It is thus crucial that we improve our understanding of the etiology of the disease. Social disadvantage likely plays an important role in Alzheimer's, in part because it modifies the risk of risks. Despite theoretical reasoning that social disadvantage should be associated with the risk of ADRD, results from clinical and behavioral studies diverge. We propose to examine whether domains of social inequality are associated with survival rates derived from a novel method that uses accelerated declines in cognitive functioning, which are known to precede ADRD, as a biomarker for the disease. The aims are to examine whether Race/Ethnicity, educational attainment, occupational complexity, and gender/sexuality are indicators of risk of Alzheimer's-related declines. This study further responds to an NIA call to study the role of health disparities in determining risk of ADRD pathology (PA-15-349). This study thus addresses NIA Goal B by improving our understanding of societal factors influencing cognitive decline and the risk of ADRD, and helps to improve our understanding of correlates of ADRD (NIA Goal D). !