2025/03/31 by Eleni Palpatzis, Müge Akinci, Marina García-Prat +13 · 1 voice
Psychology · Social Sciences · Medicine · #Grief, Bereavement, and Mental Health #Health disparities and outcomes #Dementia and Cognitive Impairment Research
paper · doi:10.1212/wnl.0000000000213377
openalex publication_date 2025/03/31 · openalex created_date 2025/04/01 · openalex updated_date 2026/07/31
BACKGROUND AND OBJECTIVES: The prevalence and impact of stressful life events (SLEs) on age-related and Alzheimer disease (AD)-related pathways may depend on social determinants including gender and education. We investigated whether specific SLEs are associated with AD pathology and neurodegeneration and how these associations differ by gender and education. METHODS: This cross-sectional study included cognitively unimpaired participants, most with a family history of sporadic AD, from the ALzheimer's and FAmilies (ALFA) cohort, based in Barcelona, Spain. Participants had available assessments on occurrence and type of lifetime SLEs and lumbar puncture and/or structural MRI. We performed multiple regression analyses to examine the associations of specific SLE type with (1) AD pathologies (CSF phosphorylated tau 181 [p-tau181] and β-amyloid [Aβ] 42/40) and (2) neurodegeneration markers (CSF neurogranin and GM volumes voxel-wise) including interaction and stratification analyses by gender (women/men) and education. RESULTS: = 0.007). The associations with Aβ42/40 were driven by less educated participants and men and associations with p-tau181 and neurogranin driven by women. Unemployment and economic loss were associated with lower GM volumes in limbic and frontal areas, driven by more educated participants and men and by women, respectively. DISCUSSION: Older adults at risk of cognitive decline with less education and women may be more susceptible to experience more SLEs. Men who have experienced widowhood and unemployment and women who have experienced financial difficulties may benefit from interventions.