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

被引：83

作者：

Adkins-Jackson, Paris B. ^{[1
,2
]}

George, Kristen M. ^{[3
]}

Besser, Lilah M. ^{[4
]}

Hyun, Jinshil ^{[5
]}

Lamar, Melissa ^{[6
,7
]}

Hill-Jarrett, Tanisha G. ^{[8
]}

Bubu, Omonigho M. ^{[9
,10
,11
]}

Flatt, Jason D. ^{[12
]}

Heyn, Patricia C. ^{[13
]}

Cicero, Ethan C. ^{[14
]}

Zarina Kraal, A. ^{[15
]}

Pushpalata Zanwar, Preeti ^{[16
,17
]}

Peterson, Rachel ^{[18
]}

Kim, Boeun ^{[19
]}

Turner, Robert W., II ^{[20
]}

Viswanathan, Jaya

Kulick, Erin R. ^{[21
]}

Zuelsdorff, Megan ^{[22
,23
]}

Stites, Shana D. ^{[24
]}

Arce Renteria, Miguel ^{[25
]}

Tsoy, Elena ^{[26
,27
]}

Seblova, Dominika ^{[28
]}

Ng, Ted K. S. ^{[29
,30
]}

Manly, Jennifer J. ^{[31
]}

Babulal, Ganesh ^{[32
,33
,34
,35
]}

机构：

[1] Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA

[2] Columbia Univ, Dept Sociomed Sci, Mailman Sch Publ Hlth, New York, NY USA

[3] Univ Calif Davis, Sch Med, Dept Publ Hlth Sci, Davis, CA USA

[4] Univ Miami, Comprehens Ctr Brain Hlth, Miller Sch Med, Miami, FL USA

[5] Albert Einstein Coll Med, Saul R Korey Dept Neurol, Bronx, NY USA

[6] Rush Univ, Med Ctr, Rush Alzheimers Dis Ctr, Chicago, IL USA

[7] Rush Univ, Med Ctr, Dept Psychiat & Behav Sci, Chicago, IL USA

[8] Univ Calif San Francisco, Dept Neurol, Memory & Aging Ctr, San Francisco, CA USA

[9] NYU, Grossman Sch Med, Dept Psychiat, New York, NY USA

[10] NYU, Grossman Sch Med, Dept Populat Hlth, New York, NY USA

[11] NYU, Grossman Sch Med, Dept Neurol, New York, NY USA

[12] Univ Nevada, Sch Publ Hlth, Dept Social & Behav Hlth, Las Vegas, NV USA

[13] Marymount Univ, Ctr Optimal Aging, Arlington, VA USA

[14] Emory Univ, Nell Hodgson Woodruff Sch Nursing, Atlanta, GA USA

[15] Columbia Univ, Dept Neurol, New York, NY USA

[16] Thomas Jefferson Univ, Jefferson Coll Populat Hlth, Appl Hlth Econ & Outcomes Res & Hlth Policy, Philadelphia, PA USA

[17] Univ Southern Calif, NIA Funded Network Life Course & Hlth Dynam & Dis, Los Angeles, CA USA

[18] Univ Montana, Sch Publ & Community Hlth Sci, Missoula, MT USA

[19] Johns Hopkins Univ, Sch Nursing, Baltimore, MD USA

[20] George Washington Univ, Clin Res & Leadership, Neurol, Washington, DC USA

[21] Temple Univ, MPH Dept Epidemiol & Biostat, Philadelphia, PA USA

[22] Univ Wisconsin, Alzheimers Dis Res Ctr, Sch Nursing, Madison, WI USA

[23] Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI USA

[24] Univ Penn, Perelman Sch Med, MA Dept Psychiat, Philadelphia, PA USA

[25] Columbia Univ, Med Ctr, Taub Inst Res Alzheimers Dis & Aging Brain, Dept Neurol, New York, NY USA

[26] Univ Calif San Francisco, Memory & Aging Ctr, Dept Neurol, Global Brain Hlth Inst, San Francisco, CA USA

[27] Trinity Coll Dublin, San Francisco, CA USA

[28] Charles Univ Prague, Fac Med 2, Prague, Czech Republic

[29] Arizona State Univ, Edson Coll Nursing & Hlth Innovat, Phoenix, AZ USA

[30] Arizona State Univ, Ctr Innovat Hlth & Resilient Aging, Phoenix, AZ USA

[31] Columbia Univ, Dept Neurol, New York, NY USA

[32] Washington Univ, Dept Neurol, Sch Med, St Louis, MO USA

[33] Washington Univ, Inst Publ Hlth, St Louis, MO USA

[34] George Washington Univ, Dept Clin Res & Leadership, Sch Med & Hlth Sci, Washington, DC USA

[35] Univ Johannesburg, Fac Humanities, Dept Psychol, Johannesburg, South Africa

来源：

ALZHEIMERS & DEMENTIA | 2023年 / 19卷 / 07期

关键词：

ADRD; Alzheimer's disease; classism; dementia; Ecological Systems Theory; genderism; macrosystem; racism; sexism; social determinants of health; structural determinants; LIFE-COURSE APPROACH; CLIMATE-CHANGE; HEALTH; COGNITION; INTERSECTIONALITY; ACCULTURATION; PERSPECTIVE; IMMIGRANTS; GENDERISM; PEOPLE;

D O I：

10.1002/alz.13027

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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. DISCUSSIONUnder 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. HighlightsEcological 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.

引用

页码：3171 / 3185

页数：15

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