Publications [#377387] of Ahmad Hariri

Journal Articles

1. Reuben, A; Richmond-Rakerd, LS; Milne, B; Shah, D; Pearson, A; Hogan, S; Ireland, D; Keenan, R; Knodt, AR; Melzer, T; Poulton, R; Ramrakha, S; Whitman, ET; Hariri, AR; Moffitt, TE; Caspi, A (2024). Dementia, dementia's risk factors and premorbid brain structure are concentrated in disadvantaged areas: National register and birth-cohort geographic analyses.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 20(5), 3167-3178. [doi]
   (last updated on 2024/10/04)

   Abstract:
   

   Introduction

   Dementia risk may be elevated in socioeconomically disadvantaged neighborhoods. Reasons for this remain unclear, and this elevation has yet to be shown at a national population level.

   Methods

   We tested whether dementia was more prevalent in disadvantaged neighborhoods across the New Zealand population (N = 1.41 million analytic sample) over a 20-year observation. We then tested whether premorbid dementia risk factors and MRI-measured brain-structure antecedents were more prevalent among midlife residents of disadvantaged neighborhoods in a population-representative NZ-birth-cohort (N = 938 analytic sample).

   Results

   People residing in disadvantaged neighborhoods were at greater risk of dementia (HR per-quintile-disadvantage-increase = 1.09, 95% confidence interval [CI]:1.08-1.10) and, decades before clinical endpoints typically emerge, evidenced elevated dementia-risk scores (CAIDE, LIBRA, Lancet, ANU-ADRI, DunedinARB; β's 0.31-0.39) and displayed dementia-associated brain structural deficits and cognitive difficulties/decline.

   Discussion

   Disadvantaged neighborhoods have more residents with dementia, and decades before dementia is diagnosed, residents have more dementia-risk factors and brain-structure antecedents. Whether or not neighborhoods causally influence risk, they may offer scalable opportunities for primary dementia prevention.