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Uxue Zubiagirre / Paula Vázquez-Aristizabal

Salón de Actos-IIS Biogipuzkoa

06/10/23

13:30

Comorbidity and gender as mediators of socioeconomic inequalities in dementia risk: a real-world data population study

Background. Low socioeconomic status (SES), comorbidities and female sex are associated with an increased risk of dementia. The aim of this study was to measure the mediating effect of comorbidity and gender on the excess risk due to SES in relation to the incidence and prevalence of dementia in the general population.
Methods. A retrospective and observational study using real-world data analysed all people over 60 who were registered with the Basque Health Service in Gipuzkoa. The study measured income level, the Charlson comorbidity index (CCI), age and sex. The prevalence and incidence of dementia according to SES were analysed using logistic regression and Poisson regression models, respectively, adjusted by sex, comorbidity and age. We estimated the combined mediation effect of gender and comorbidity on the prevalence of dementia associated with SES.
Results. Of the 221,777 individuals, 3.85% (8,549) had a diagnosis of dementia as of 31 December 2021. Classification by the CCI showed a gradient with 2.90% in CCI 0-1, 10.60% in CCI 2-3 and 18.01% in CCI>3. Both low SES (OR=1.13 with CIs 1.18 and 1.07) and gender (OR=1.12 with CIs 1.12 and 1.12) were associated with a higher prevalence of dementia. However, in the CCI-adjusted model, women had an increased risk of dementia, while SES was no longer statistically significant. The incidence analysis produced similar results, although SES was not significant in any model. The CCI was significantly higher for men and for people with low SES. The mediation was statistically significant, and the CCI and gender explained 57.2% of the low SES effect.
Conclusions. Comorbidity and female sex act as mediators in the increased risk of dementia associated with low SES. Given the difference in the prevalence of comorbidities by SES, individual interventions to control comorbidities could not only prevent dementia but also reduce inequalities, as the risk is greater in the most disadvantaged population.


Development of Customized Bioinks for 3D Printing Dynamic Cancer Models

There is an unmet need for monitorable cancer models that better represent the complex native environment found in human tissues. The development of solid tumor micromodels based on printed decellularized extracellular matrices (dECMs) offers a step in this direction, with the biomolecule-rich matrix of dECM inks allowing cell growth in a three-dimensional (3D) and natural environment. To this aim, a catalogue of biocompatible inks was prepared via chemical, mechanical and enzymatic processes. Printability was confirmed by both printing and rheological assessment and inks were combined to build complex 3D models. Representative of either skin or breast tissue, the models can be characterized using different imaging techniques. Results suggest that such in vitro 3D microtissues can be used as a powerful tool in tissue engineering and disease modelling to better understand cellular behavior and drug responses.