Differential Associations of Socioeconomic Status With Global Brain Volumes and White Matter Lesions in African American and White Adults: the HANDLS SCAN Study.
OBJECTIVE
The aim of the study was to examine interactive relations of race and socioeconomic status (SES) to magnetic resonance imaging (MRI)-assessed global brain outcomes with previously demonstrated prognostic significance for stroke, dementia, and mortality.


METHODS
Participants were 147 African Americans (AAs) and whites (ages 33-71 years; 43% AA; 56% female; 26% below poverty) in the Healthy Aging in Neighborhoods of Diversity across the Life Span SCAN substudy. Cranial MRI was conducted using a 3.0 T unit. White matter (WM) lesion volumes and total brain, gray matter, and WM volumes were computed. An SES composite was derived from education and poverty status.


RESULTS
Significant interactions of race and SES were observed for WM lesion volume (b = 1.38; η = 0.036; p = .028), total brain (b = 86.72; η = 0.042; p < .001), gray matter (b = 40.16; η = 0.032; p = .003), and WM (b = 46.56; η = 0.050; p < .001). AA participants with low SES exhibited significantly greater WM lesion volumes than white participants with low SES. White participants with higher SES had greater brain volumes than all other groups (albeit within normal range).


CONCLUSIONS
Low SES was associated with greater WM pathology-a marker for increased stroke risk-in AAs. Higher SES was associated with greater total brain volume-a putative global indicator of brain health and predictor of mortality-in whites. Findings may reflect environmental and interpersonal stressors encountered by AAs and those of lower SES and could relate to disproportionate rates of stroke, dementia, and mortality.
From the Department of Psychology (Waldstein), University of Maryland, Baltimore County, Baltimore, Maryland; Division of Gerontology and Geriatric Medicine (Waldstein, Katzel), Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Geriatric Research Education and Clinical Center (Waldstein, Katzel), Baltimore VA Medical Center, Baltimore, Maryland; Laboratory of Epidemiology and Population Sciences (Dore, Evans, Zonderman), National Institute on Aging Intramural Research Program, Baltimore, Maryland; Section of Biomedical Image Analysis (Davatzikos, Erus), Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Diagnostic Radiology (Gullapalli, Kouo), University of Maryland School of Medicine, Baltimore, Maryland; Division of Nephrology (Seliger), Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland; and Department of Statistics (Rosenberger), George Mason University, Fairfax, Virginia.
Shari R
SR
Waldstein
Gregory A
GA
Dore
Christos
C
Davatzikos
Leslie I
LI
Katzel
Rao
R
Gullapalli
Stephen L
SL
Seliger
Theresa
T
Kouo
William F
WF
Rosenberger
Guray
G
Erus
Michele K
MK
Evans
Alan B
AB
Zonderman
D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D015142:Baltimore / Q000208:ethnology; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012923:Social Class; D066127:White Matter / Q000000981:diagnostic imaging*; D044465:White People / Q000208:ethnology*