Higher Neighborhood Deprivation is Associated with Accelerated Disease Progression in Behavioral-Variant Frontotemporal Degeneration.
Penn collection
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Medicine and Health Sciences
Mental and Social Health
Public Health
Social and Behavioral Sciences
Urban Studies and Planning
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behavioral-varient frontotemporal degeneration
cognitive decline
executive function
social and structural determinants of health
brain health equity
socioeconomic status
neighborhood deprivation
area deprivation index
reserve
resilience
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Abstract
Neighborhood deprivation is associated with shorter survival, cognitive impairment and neurodegeneration in aging and Alzheimer’s disease. However, the association of neighborhood deprivation with disease progression in behavioral-variant frontotemporal degeneration (bvFTD) is unknown. METHODS: We examined associations between tertiles of neighborhood deprivation, using the Area Deprivation Index (ADI), and survival in 311 individuals clinically diagnosed with bvFTD from the Penn FTD Center. In a subset (n=161) with complete baseline data across measures of global cognition, executive function, and language, we examined the association of ADI with longitudinal change. RESULTS: Compared to adults living in the least deprived neighborhoods, those living in the most deprived neighborhoods showed shorter survival after symptom onset and faster decline in global cognition, executive and language functions, independent of genetic risk. DISCUSSION: Living in more deprived neighborhoods was associated with an accelerated disease course in bvFTD, highlighting an important socioeconomic disparity in disease prognosis.