Evidence map›Paper›PMID 37074203›Full record

ReviewAlzheimer's & dementia : the journal of the Alzheimer's Association2023

The structural and social determinants of Alzheimer's disease related dementias.

Paris B Adkins-Jackson, Kristen M George, Lilah M Besser, Jinshil Hyun, Melissa Lamar, Tanisha G Hill-Jarrett, Omonigho M Bubu, Jason D Flatt, Patricia C Heyn, Ethan C Cicero and 15 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 192 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
192citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

192 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  9. Review
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  13. Adverse policing as a social exposome pathway: Implications for depression, cognition, and dementia risk.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  14. Adverse Childhood Experiences, Depression and Subjective Cognitive Decline by Gender: A Moderated Mediation Analysis.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
    Article
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  19. Multidimensional workplace stressors differentially impact cognitive trajectories.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  20. Article

132 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Paris B Adkins-JacksonDepartments of Epidemiology & Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.ORCID 0000-0003-3618-449X
Kristen M GeorgeDepartment of Public Health Sciences, University of California, Davis School of Medicine, Davis, California, USA.
Lilah M BesserComprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, Florida, USA.
Jinshil HyunThe Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, New York, USA.
Melissa LamarRush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Tanisha G Hill-JarrettDepartment of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA.
Omonigho M BubuDepartments of Psychiatry, Population Health & Neurology, New York University Grossman School of Medicine, New York, New York, USA.
Jason D FlattDepartment of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Nevada, USA.
Patricia C HeynCenter for Optimal Aging, Marymount University, Arlington, Virginia, USA.
Ethan C CiceroNell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.
A Zarina KraalDepartment of Neurology, Columbia University, New York, New York, USA.
Preeti Pushpalata ZanwarApplied Health Economics & Outcomes Research & Health Policy, Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Rachel PetersonSchool of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA.
Boeun KimSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Robert W TurnerClinical Research & Leadership, Neurology, The George Washington University, Washington, D.C., USA.
Jaya ViswanathanBethesda, Maryland, USA.
Erin R KulickMPH Department of Epidemiology and Biostatistics, Temple University, Philadelphia, Pennsylvania, USA.
Megan ZuelsdorffSchool of Nursing, Alzheimer's Disease Research Center, and School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Shana D StitesMA Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Miguel Arce RenteríaDepartment of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, New York, USA.
Elena TsoyDepartment of Neurology, Memory and Aging Center, University of California San Francisco, Global Brain Health Institute, University of California San Francisco and Trinity College Dublin, San Francisco, California, USA.
Dominika SeblovaSecond Faculty of Medicine, Charles University, Prague, Czech Republic.
Ted K S NgEdson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.
Jennifer J ManlyDepartment of Neurology, Columbia University, New York, New York, USA.
Ganesh BabulalDepartment of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.

Funding

Research Education ComponentP30AG066512 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mary Sherman Mittelman · 2020 to 2026
$28.4M
Study of Healthy Aging in African AmericansR01AG050782 · NIA · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Paola Gilsanz, Rachel A Whitmer · 2023 to 2026
$19.1M
Lifecourse health, cerebral pathology and ethnic disparities in dementia (KHANDLE Study)R01AG052132 · NIA · UNIVERSITY OF CALIFORNIA AT DAVIS · PI GILSANZ, PAOLA, GLYMOUR, MEDELLENA MARIA · 2021 to 2025
$18.0M
Augmenting Nurse Support and EHR Integration for the Pragmatic Trial of the UCSF-BHAU01NS128913 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Katherine Laurel Possin · 2022 to 2026
$8.2M
Research Centers Collaborative Network RenewalU24AG058556 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KRITCHEVSKY, STEPHEN B., LEDERMAN, STEPHANIE · 2018 to 2025
$7.5M
Using a Health Disparity Research Framework to examine mechanisms linking Obstructive Sleep Apnea with higher Alzheimer’s disease risk in older Blacks/African-AmericansR01AG082278 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI OMONIGHO A MICHAEL Bubu · 2023 to 2026
$6.9M
Naturalistic driving as a functional neurobehavioral marker of preclinical and symptomatic Alzheimer diseaseR01AG068183 · NIA · WASHINGTON UNIVERSITY · PI BABULAL, GANESH M · 2020 to 2024
$6.7M
Research Education CoreP30AG059303 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Jennifer Jaie Manly · 2018 to 2026
$6.0M
Preclinical Alzheimer Disease and DrivingR01AG056466 · NIA · WASHINGTON UNIVERSITY · PI BABULAL, GANESH M · 2017 to 2021
$5.9M
The role structural discrimination on depression, sleep, cardiovascular disease, and cognitive declineDP1AG069874 · NIA · JOHNS HOPKINS UNIVERSITY · PI SZANTON, SARAH L · 2020 to 2024
$4.1M
The Impact of Depression and Preclinical Alzheimer Disease on Driving Among Older AdultsR01AG067428 · NIA · WASHINGTON UNIVERSITY · PI BABULAL, GANESH M · 2020 to 2024
$4.0M
Risk for Later-Life Cognitive Impairment, Neurobehavioral Dysregulation, and Dementia in Former Soccer and American Football Players: The Head Impact and Trauma Surveillance Study (HITSS)R01NS119651 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ALOSCO, MICHAEL · 2021 to 2025
$3.9M
NIA NIH HHS DP1 AG069874NIA NIH HHS K01 AG054762NIA NIH HHS K01 AG056669NIA NIH HHS K01 AG063895NIA NIH HHS K23 AG065442NIA NIH HHS K23 AG068534NIA NIH HHS K99 AG066932NIA NIH HHS L30 AG064670NIA NIH HHS P30 AG059303NIA NIH HHS P30 AG066512NIA NIH HHS R00 AG066932NIA NIH HHS R00 AG073457NIA NIH HHS R01 AG050782NIA NIH HHS R01 AG052132NIA NIH HHS R01 AG056466NIA NIH HHS R01 AG062711NIA NIH HHS R01 AG067428NIA NIH HHS R01 AG068183NIA NIH HHS R01 AG074302NIA NIH HHS R01 AG082278NIA NIH HHS R03 AG063303NIA NIH HHS R13 AG071313NIA NIH HHS R13 AG072884NIA NIH HHS R21 AG075291NIA NIH HHS R21 AG080410NIA NIH HHS R24 AG065170NIA NIH HHS RF1 AG050782NIA NIH HHS T32 AG078115NIA NIH HHS U24 AG058556NINDS NIH HHS R01 NS119651NINDS NIH HHS R25 NS117367NINDS NIH HHS U01 NS128913
6 · The paper itself

Abstract

introductionThe projected growth of Alzheimer's disease (AD) and AD-related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD.

methodsIn this review, we employ Bronfenbrenner's ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes.

resultsBronfenbrenner defined the "macrosystem" as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper. DISCUSSION: Under Bronfenbrenner's macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research. HIGHLIGHTS: Ecological systems theory links structural/social determinants to AD/ADRD. Structural/social determinants accrue and interact over the life course to impact AD/ADRD. Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws). Most macro-level determinants have been understudied in the AD/ADRD literature.

Indexed as

Alzheimer DiseaseDementiaHumansSocial Determinants of HealthADRDAlzheimer's diseaseclassismdementiaEcological Systems Theorygenderismmacrosystemracismsexismsocial determinants of healthstructural determinants

Identifiers

PMID37074203
PMCPMC10599200

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.