Social exposome and brain health outcomes of dementia across Latin America

Joaquin Migeot, Stefanie D. Pina-Escudero, Hernan Hernandez, Raul Gonzalez-Gomez, Agustina Legaz, Sol Fittipaldi, Elisa de Paula França Resende, Claudia Duran-Aniotz, Jose Alberto Avila-Funes, Maria I. Behrens, Martin A. Bruno, Juan Felipe Cardona, Nilton Custodio, Adolfo M. García, Maria E. Godoy, Kun Hu, Serggio Lanata, Brian Lawlor, Francisco Lopera, Marcelo Adrian Maito, Diana L. Matallana, Bruce Miller, J. Jaime Miranda, Maira Okada Oliveira, Pablo Reyes, Hernando Santamaria-Garcia, Andrea Slachevsky, Ana L. Sosa, Leonel T. Takada, Jacqueline M. Torres, Sven Vanneste, Victor Valcour, Olivia Wen, Jennifer S. Yokoyama, Katherine L. Possin and Agustin Ibanez ()
Additional contact information
Joaquin Migeot: Metropolitan Region of Santiago
Stefanie D. Pina-Escudero: University of California
Hernan Hernandez: Metropolitan Region of Santiago
Raul Gonzalez-Gomez: Metropolitan Region of Santiago
Agustina Legaz: Metropolitan Region of Santiago
Sol Fittipaldi: Metropolitan Region of Santiago
Elisa de Paula França Resende: University of California
Claudia Duran-Aniotz: Metropolitan Region of Santiago
Jose Alberto Avila-Funes: Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México
Maria I. Behrens: Metropolitan Region of Santiago
Martin A. Bruno: Universidad Católica de Cuyo
Juan Felipe Cardona: Universidad del Valle
Nilton Custodio: Peruvian Institute of Neurosciences
Adolfo M. García: University of California
Maria E. Godoy: Metropolitan Region of Santiago
Kun Hu: Harvard Medical School
Serggio Lanata: University of California
Brian Lawlor: Trinity College Dublin
Francisco Lopera: Universidad de Antioquia
Marcelo Adrian Maito: Ciudad Autónoma de Buenos Aires
Diana L. Matallana: Hospital Universitario Fundación Santa Fe
Bruce Miller: University of California
J. Jaime Miranda: University of Sydney
Maira Okada Oliveira: University of California
Pablo Reyes: Pontificia Universidad Javeriana
Hernando Santamaria-Garcia: Pontificia Universidad Javeriana
Andrea Slachevsky: Metropolitan Region of Santiago
Ana L. Sosa: Ciudad de México
Leonel T. Takada: University of São Paulo
Jacqueline M. Torres: University of California
Sven Vanneste: Trinity College Dublin
Victor Valcour: University of California
Olivia Wen: Boston College
Jennifer S. Yokoyama: University of California
Katherine L. Possin: University of California
Agustin Ibanez: Metropolitan Region of Santiago

Nature Communications, 2025, vol. 16, issue 1, 1-18

Abstract: Abstract A multidimensional social exposome (MSE)—the combined lifespan measures of education, food insecurity, financial status, access to healthcare, childhood experiences, and more—may shape dementia risk and brain health over the lifespan, particularly in underserved regions like Latin America. However, the MSE effects on brain health and dementia are unknown. We evaluated 2211 individuals (controls, Alzheimer’s disease, and frontotemporal lobar degeneration) from a non-representative sample across six Latin American countries. Adverse exposomes associate with poorer cognition in healthy aging. In dementia, more complex exposomes correlate with lower cognitive and functional performance, higher neuropsychiatric symptoms, and brain structural and connectivity alterations in frontal-temporal-limbic and cerebellar regions. Food insecurity, financial resources, subjective socioeconomic status, and access to healthcare emerge as critical predictors. Cumulative exposome measures surpass isolated factors in predicting clinical-cognitive profiles. Multiple sensitivity analyses confirm our results. Findings highlight the need for personalized approaches integrating MSE across the lifespan, emphasizing prevention and interventions targeting social disparities.

Date: 2025
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DOI: 10.1038/s41467-025-63277-6

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