Perceived social status modifies associations of plasma Alzheimer’s disease biomarkers on cognitive performance among Foreign Born Hispanic/Latinos

Abstract

Background

Foreign born (FB) adults from Latin America are projected to account for the largest proportion of the aging immigrant population in the United States (U.S.) Migration related stressors may increase vulnerability for impairments of stress regulatory systems that are vital in maintaining brain health. We assessed how subjective social status, an individual’s perceived sense of standing in society may be associated with brain health and cognitive performance among community dwelling FB Hispanic/Latinos.

Method

Analyses included 133 FB adults (ages 22-85) with beta-amyloid (Aβ42, Aβ40), phosphorylated tau (p-tau181), neurofilament light (NfL), glial fibrillary acidic protein (GFAP), cardiometabolic, sociodemographic, sociocultural data and concurrent cognitive scores, assessed with the NIH Cognition Toolbox. Participants used the McArthur Scale, a 10-rung ladder representative of social status in the U.S., to indicate their standing relative to all others. Descriptive statistics were calculated to examine differences by perceived social status tertiles, (i.e., Low (1-3), Average (4-5), High (6-10). Cross sectional multivariable linear regression models estimated the independent effects of biomarkers on outcome scores for episodic memory, processing speed, and total cognition. Model one included age, sex. Model two added education, income, employment, and health insurance. Model three adjusted for covariates in model two and included biological indicators associated with brain health (i.e., glucose, systolic blood pressure, triglycerides). Model four included nativity factors (i.e., age of migration, years of acculturation). An interaction term between plasma biomarker and perceived status examined whether perceived status modified the relationship between plasma biomarker and cognitive outcome.

Result

Over 27.1% of FB Hispanic/Latinos reported low perceived status. Compared to those with average and high status, participants categorized as low status, reported fewer years of residence in the U.S. (P = 0.020) In multivariable adjusted models, perceived status modified associations between GFAP (P<0.001) and NfL (P<0.001) on composite scores of total cognition (P<0.001) and NfL (P<0.001) and Aβ42/40 (P<0.0001) on episodic memory and processing speed (P<0.001).

Conclusion

Perceived status among undocumented FB Hispanic/Latino adults was associated with lower scores on cognitive tasks sensitive to stress, age related decline and neurological impairments. Future studies should explore biological mechanisms through which perceived status may influence brain health and cognitive aging.