AbstractBackgroundDiverse ethnic ancestry and adverse social health determinants are increasingly recognized to impact dementia on multiple dimensions: genetically and environmentally determined risk, clinical presentation, detection, and the utility of cognitive testing and management. Most evidence originates from ethnically diverse cohorts in North America, with little representation of other world regions. We aimed to assess dementia clinical and neuroimaging phenotype in individuals of Middle Eastern and Northern African (MENA) descent, a population severely underrepresented in brain health research.MethodsThe Alzheimer’s and atypical dementias in Israelis of diverse ancestry and disparate social health determinants (ADIDAS) project started on January 1st, 2022, and will prospectively recruit 200 individuals aged 40‐80 years reporting a new cognitive decline. The ADIDAS protocol includes APOE genotyping, structured assessment of early‐to‐late life social determinants, Israeli neighbourhood disadvantage index, medical history, vascular risk factors, cognitive testing, plasma Alzheimer’s biomarkers (Aβ40, Aβ42, total‐tau, p‐tau181, and NfL), and brain MRI. Ancestry was defined using participants and paternal country of birth. Countries were grouped into MENA, European, or neither, as defined by the World Bank. The project aims to assess the relationship between ethnic ancestry and associated social health determinants as predictors of brain neurodegeneration evident on neuroimaging and plasma biomarkers.Preliminary ResultsAs of January 1st, 2023, the ADIDAS cohort recruited 51 participants (55% female, mean age 65.8±8.4 years) of MENA (n = 24), European (n = 23), and neither (n = 3) ancestry. A preliminary comparison of MENA and European groups reveals MENA in our cohort are on average younger (63.87±8.9 vs. 68.3±8.2 years), have fewer years of schooling(11.7±2.5 vs. 16.2±3.4 years), and more likely to obtain only elementary or vocational education (75% vs. 13%). MENA were more likely to score poor results on cognitive testing‐ MMSE (21.6±4.9 vs. 24.8±5.5), receive a higher clinical dementia rating sum of boxes (3.4±2.5 vs. 1.45±1.4), and a lower carriage rate of apoE4 allele (11% vs. 30%).ConclusionPreliminary non‐matched comparison suggests MENA with early‐stage cognitive impairment have a different social, cognitive, and genetic risk profile than individuals of European ancestry. Results of plasma biomarkers profile and MRI‐related structural changes will be shared at AAIC2023.
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