Yeah, so I’d be happy to talk about our Healthy Brain Initiative, which is an NIH-funded study that allows us to look at brain health in a community-based sample. So this is not a clinic sample. These are people from the community. And we tried to make it as real-world of a longitudinal study as we could, so there are very few exclusion criteria. So you have to be over 50 and be willing to do all the parts of the study...
Yeah, so I’d be happy to talk about our Healthy Brain Initiative, which is an NIH-funded study that allows us to look at brain health in a community-based sample. So this is not a clinic sample. These are people from the community. And we tried to make it as real-world of a longitudinal study as we could, so there are very few exclusion criteria. So you have to be over 50 and be willing to do all the parts of the study. But the only exclusion criteria are active cancer, an access one or two psychiatric diagnoses, or an unstable medical condition that would preclude your participation in a longitudinal study. So these are people who have lots of comorbidities and lots of different types of complaints. We want to really understand what puts people at risk for brain diseases like Alzheimer’s or other cognitive or neurodegenerative disorders. So we’ve been enrolling people. Our active cohort is about 500 people. But in this study, we use the data from the first 341. And we looked at their cross-sectional data. So their baseline data. And this included their cognitive performance, looking at episodic memory, language, executive function, attention, et cetera, their MRI imaging, particularly focusing on hippocampal volumes and white matter hyperintensities, and then their blood-based biomarkers. This included A-beta 42/40 ratios, p-tau217, NFL, and GFAP. And then we had lots of different sociodemographic characteristics, but things like age, sex, race, ethnicity, language, nativity, so where they were born in the U.S. or outside the U.S., their socioeconomic status, their area deprivation index, which gives us a sense of sort of their neighborhood characteristics and resources, and their living conditions, whether they lived with someone or they lived alone. And then we used a multivariable linear regression modeling to sort of examine these associations between their social demographics and all the different brain health outcomes. So the mean age of the sample was about 69, about 70% of the sample were women. What we found were people who were older, women participants, people from racial ethnic minorities, so Black and Hispanic individuals, those with lower socioeconomic status, people living in neighborhoods with low or high area deprivation scores, that means low neighborhood resources, and those born outside the U.S. actually performed much worse across the various cognitive domains, while those that actually spoke Spanish scored better on tests of episodic memory. So it’s not just whether what group you’re from and your language, there’s a lot of other factors that can go into this and has a lot to do with what of your personal resources and your neighborhood resources. We have found that older individuals, women and Hispanics had worse brain health measures. And that was looking at hippocampal volumes and white matter hyperintensities. Whereas other racial groups and those born outside the U.S. actually had better brain health measures when we looked at MRI. So there’s a little bit of a disconnect there, right? So again, I think this is a really important thing. We need to understand how each of these sociodemographic factors are interplaying in the development of brain diseases. We also found that older individuals and people who are Hispanic had worse brain health and Black individuals and women had better brain health when we looked at blood-based biomarkers. So again, there’s a little bit of a disconnect where we’re seeing from MRI to blood-based biomarkers. And so this helps us understand that, you know, we really need to understand what, what is the underlying cause of these differences and, you know, do different groups have sort of have different expression of disease in different ways. So for example, in blood-based biomarkers, African-American individuals might have different expression of these biomarkers and that would lead to disease than people from other racial, ethnic backgrounds. And the interplay of social and economic determinants of health may really be associated with that longitudinal change that we’re seeing, particularly in terms of vascular brain health. So I think that these type of studies are critically important so that we can try to better translate what we’re finding in longitudinal studies to apply to real world care.
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