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Editorial
October 2, 2019

Social health and brain health
Do neurologists also have a duty to treat social ills?

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November 12, 2019 issue
93 (20) 873-875

Abstract

Drug trials in Alzheimer disease and related dementias remain unsuccessful. However, evidence demonstrating how these illnesses affect people based on socioeconomic1 and related modifiable factors2 suggests that perhaps we should also target social determinants of health. These determinants underlie how social conditions—structures, institutions, relationships—influence health and are alterable throughout a person’s lifespan. Thus, understanding how social determinants influence brain health is crucial to inform public policy, identify high-risk individuals for cost-effective risk reduction, and improve population health interventions so all persons can thrive. But details of social determinants in neurologic conditions remain unclear and, compounding the complexity, these conditions change alongside social, political, and economic circumstances.

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References

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Yaffe K, Falvey C, Harris TB, et al. Effect of socioeconomic disparities on incidence of dementia among biracial older adults: prospective study. BMJ 2013;347:f7051.
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Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet 2017;390:2673–2734.
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Grasset L, Glymour MM, Elfassy T, et al. Relation between 20-year income volatility and brain health in midlife: The CARDIA study. Neurology 2019;93:e1890–e1899.
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Salinas J, Beiser A, Himali JJ, et al. Associations between social relationship measures, serum brain-derived neurotrophic factor, and risk of stroke and dementia. Alzheimers Dement 2017;3:229–237.
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Elfassy T, Swift SL, Glymour MM, et al. Associations of income volatility with incident cardiovascular disease and all-cause mortality in a US cohort. Circulation 2019;139:850–859.
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Chetty R, Stepner M, Abraham S, et al. The association between income and life expectancy in the United States, 2001-2014. JAMA 2016;315:1750–1766.
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Information & Authors

Information

Published In

Neurology®
Volume 93Number 20November 12, 2019
Pages: 873-875
PubMed: 31578301

Publication History

Published online: October 2, 2019
Published in print: November 12, 2019

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Disclosure

The author reports no disclosures. Go to Neurology.org/N for full disclosures.

Study Funding

No targeted funding reported.

Authors

Affiliations & Disclosures

Joel Salinas, MD, MBA, MSc
From the Henry and Allison McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Framingham Heart Study; and Harvard Center for Population and Development Studies, Departments of Epidemiology and Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA.
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Notes

Correspondence Dr. Salinas [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the editorial.

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Cited By
  1. Allostatic interoception and brain health: From neurodegeneration to social adversities, Encyclopedia of the Human Brain, (204-221), (2025).https://doi.org/10.1016/B978-0-12-820480-1.00025-5
    Crossref
  2. Re-Engaging Individuals & Societies for Structural Evolution: A Brain Health Equity Neuropsychology Research Framework, Archives of Clinical Neuropsychology, 38, 3, (347-364), (2023).https://doi.org/10.1093/arclin/acad011
    Crossref
  3. The relevance of social and commercial determinants for neurological health, The Lancet Neurology, 21, 12, (1151-1160), (2022).https://doi.org/10.1016/S1474-4422(22)00428-8
    Crossref
  4. What's happening in Equity, Diversity & Inclusion, Neurology, 94, 14, (620-620), (2020)./doi/10.1212/WNL.0000000000009226
    Abstract
  5. What's happening in Innovations in Care Delivery, Neurology, 93, 23, (1001-1001), (2019)./doi/10.1212/WNL.0000000000008598
    Abstract
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