Educational disparities in brain health and dementia across Latin America and the United States.
Ana L Sosa Ortiz, Raul Gonzalez-Gomez, Marcelo Adrián Maito, Josephine Cruzat, Vicente Medel, Pablo Reyes, Diana L Matallana, Juan F Cardona, Ignacio L Brusco, Martín A Bruno, Agustina Legaz, Stefanie D Pina-Escudero, Sebastián Moguilner, Hernán Hernández, Rafael Cocchi, Carlos Coronel-Olivero, Enzo Tagliazuchi, Hernando Santamaria Garcia, Maria E Godoy, Agustin Ibañez, Adolfo M García, Katherine L Possin, Leonel T Takada, Shireen Javandel, María I Behrens, Jennifer S Yokoyama, Victor Valcour, Brian Lawlor, Sandra Baez, Cecilia Gonzalez Campo, Carolina Ochoa-Rosales, Bruce Miller, José Alberto Avila-Funes, Elisa de Paula França Resende, Maira Okada de Oliveira, Francisco Lopera, Kun Hu, Nilton Custodio, Andrea Slachevsky, Joaquín Migeot
Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association
2024;20(9):5912-5925
PMID: 39136296
Abstract
BACKGROUND
Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown.
METHODS
A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type.
RESULTS
Education influenced brain measures, explaining 24%-98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions.
DISCUSSION
The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research.
HIGHLIGHTS
Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). Latin American cohorts have lower educational levels compared to the those in the United States. Educational disparities majorly drive brain health differences between regions. Educational differences were significant in both conditions, but more in AD than FTLD. Education stands as a critical factor in classifying aging and dementia across regions.
© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
Address:
Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.; Universidad de los Andes, Bogotá, D.C., Colombia.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.; Global Brain Health Institute, University of California, San Francisco, California, USA.; Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Valparaíso, Chile.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Departamento de Física, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Instituto de Física de Buenos Aires (FIBA -CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.; Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.; Center for Memory and Cognition, Hospital Universitario San Ignacio Bogotá, San Ignacio, Bogotá D.C., Colombia.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Global Brain Health Institute, University of California, San Francisco, California, USA.; Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Global Brain Health Institute, University of California, San Francisco, California, USA.; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.; Dirección de Enseñanza, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, D.C., México.; Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile.; Memory and Neuropsychiatric Center (CMYN), Neurology Department, Hospital del Salvador & Faculty of Medicine, University of Chile, Santiago, Chile.; Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Program - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile.; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.; Faculty of Medicine, University of Chile, Santiago, Chile.; Centro de Investigación Clínica Avanzada (CICA), Universidad de Chile, Santiago, Chile.; Unit Cognitive Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru.; Facultad de Psicología, Universidad del Valle, Cali, Colombia.; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Instituto de Ciencias Biomédicas, Universidad Católica de Cuyo, San Juan, Argentina.; Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, D.C., México.; Universidade de São Paulo, São Paulo, Brazil.; Global Brain Health Institute, University of California, San Francisco, California, USA.; Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.; Global Brain Health Institute, University of California, San Francisco, California, USA.; Cognitive Neurology and Behavioral Unit (GNCC), University of São Paulo, São Paulo, Brazil.; Neurosicence Research Group (GNA), Universidad de Antioquia, Medellín, Antioquia, Colombia.; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile.; Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.; Global Brain Health Institute, University of California, San Francisco, California, USA.
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MeSH Terms:
Humans,
Latin America,
Male,
Female,
United States,
Brain,
Aged,
Magnetic Resonance Imaging,
Alzheimer Disease,
Educational Status,
Middle Aged,
Frontotemporal Lobar Degeneration,
Dementia
