Abstract
There is an increasing interest in identifying aging-related factors which may be permissive of Alzheimer’s Disease (AD) emergence. We previously used machine learning to derive an index of neuroanatomic risk of dementia called AD pattern similarity (AD-PS) score using MRIs obtained in the Atherosclerosis Risk in Communities (ARIC) study. Here, we investigate the potential of the AD-PS scores as a brain-focused measure of biologic age. Among 1970 ARIC participants with MRI collected at ARIC Visit 5, we related AD-PS scores to three measures of aging: mortality (n=356) over 8 years of follow-up; an a priori panel of 32 proteins related to aging (N=1647); and a deficit accumulation index (DAI) based on 38 health-related measures. We found lower AD-PS scores associated with significantly lower mortality (HR=0.58, CI-95%, [0.45 - 0.75], p < 0.001) after adjusting for age, race, smoking and hypertension. Among the 32 proteins, nine were significantly associated to AD-PS scores (p < 0.05) with 4 remaining significant adjusting for multiple comparisons (Growth/differentiation factor 15, Tumor necrosis factor receptor superfamily member 1A and 1B and Collagen alpha-1(XVIII) chain). Finally, in a linear regression model after adjusting for age, race, sex, hypertension and smoking, AD-PS scores were associated with the DAI (p < 0.001). The consistent patterns of associations suggest that a data-driven measure of AD neuroanatomic risk may be capturing aspects of biologic age in older adults.
Highlights
Brazil is among the countries hit hardest by COVID-19, and older adults are among the vulnerable groups
As younger Brazilians are increasingly vulnerable to COVID-19 and experiencing severe outcomes, policy makers need to be more attentive to the health needs of households that comprise older and younger cohorts, which are more prevalent in poor and marginalized segments of the population
Older adults who live alone in Brazil are more likely to have worse health conditions and lower socioeconomic status than older adults who live with others [45], both of which are risk factors for hospitalization and death from COVID19
Summary
Brazil is among the countries hit hardest by COVID-19, and older adults are among the vulnerable groups. Intergenerational coresidence and interdependence among family members, both prevalent in Brazil, likely increase social and physical contact and potential infection. Intergenerational coresidence often reflects the needs and resources of older and younger generations and facilitates ease of support exchanges between family members. Prior research in Latin American and Caribbean countries shows that support exchanges with children and extended family can benefit older adults’ health [14, 15]. Those who lived alone may have increased risks of poor mental and physical health due to a lack of support and social isolation [17]. Research conducted during the early stages of the pandemic in Brazil showed that adults aged 60 or older were more likely than adults ages 18 to 59 to adhere to preventive measures [18] and to stay home [19]
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