The impacts of social determinants of health and cardiometabolic factors on cognitive and functional aging in Colombian underserved populations

Global initiatives call for further understanding of the impact of inequity on aging across underserved populations. Previous research in low- and middle-income countries (LMICs) presents limitations in assessing combined sources of inequity and outcomes (i.e., cognition and functionality). In this study, we assessed how social determinants of health (SDH), cardiometabolic factors (CMFs), and other medical/social factors predict cognition and functionality in an aging Colombian population. We ran a cross-sectional study that combined theory- (structural equation models) and data-driven (machine learning) approaches in a population-based study (N = 23,694; M = 69.8 years) to assess the best predictors of cognition and functionality. We found that a combination of SDH and CMF accurately predicted cognition and functionality, although SDH was the stronger predictor. Cognition was predicted with the highest accuracy by SDH, followed by demographics, CMF, and other factors. A combination of SDH, age, CMF, and additional physical/psychological factors were the best predictors of functional status. Results highlight the role of inequity in predicting brain health and advancing solutions to reduce the cognitive and functional decline in LMICs.Fil: Santamaria Garcia, Hernando. Pontificia Universidad Javeriana; Colombia. Hospital Universitario San Ignacio; Colombia. University of California; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Moguilner, Sebastian Gabriel. Universidad de San Andrés; Argentina. Massachusetts General Hospital; Estados Unidos. Universidad Adolfo Ibañez; ChileFil: Rodriguez Villagra, Odir Antonio. Universidad de Costa Rica; Costa RicaFil: Botero Rodriguez, Felipe. Pontificia Universidad Javeriana; ColombiaFil: Pina Escudero, Stefanie Danielle. University of California; Estados UnidosFil: O’Donovan, Gary. Universidad Adolfo Ibañez; Chile. Universidad de los Andes; ColombiaFil: Albala, Cecilia. Universidad de Chile; ChileFil: Matallana, Diana. Fundacion Santa Fe de Bogota; Colombia. Hospital Universitario San Ignacio; Colombia. Pontificia Universidad Javeriana; ColombiaFil: Schulte, Michael. Universidad Adolfo Ibañez; ChileFil: Slachevsky, Andrea. Universidad del Desarrollo; Chile. Universidad de Chile; ChileFil: Yokoyama, Jennifer S.. University of California; Estados UnidosFil: Possin, Katherine. University of California; Estados UnidosFil: Ndhlovu, Lishomwa C.. Weill Cornell Medicine; Estados UnidosFil: Al-Rousan, Tala. University of California at San Diego; Estados UnidosFil: Corley, Michael J.. Weill Cornell Medicine; Estados UnidosFil: Kosik, Kenneth. University of California; Estados UnidosFil: Muniz Terrera, Graciela. University of Edinburgh; Reino Unido. Ohio University; Estados UnidosFil: Miranda, J. Jaime. George Institute For Global Health; Australia. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú. Universidad Peruana Cayetano Heredia; PerúFil: Ibañez, Agustin Mariano. Universidad de San Andrés; Argentina. Trinity College Dublin; Irlanda. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of California; Estados Unidos. Universidad Adolfo Ibañez; Chil