The exposome of brain aging across 34 countries

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dc.contributor.authorLegaz, Agustina
dc.contributor.authorMorales Sepúlveda, Juan Pablo
dc.contributor.authorIbáñez, Agustín
dc.coverage.spatialUnited Kingdom
dc.date.accessioned2026-04-06T16:48:42Z
dc.date.available2026-04-06T16:48:42Z
dc.date.issued2026-04-03
dc.description.abstractThe physical and social exposome affects human aging, and brain clocks may track its effects. However, most studies neglect multidomain exposures (physical, social and political) across diverse settings globally and their associations with brain aging. In this study, we characterized the associations between 73 country-level physical and social exposomal factors and multimodal brain age in 18,701 participants from 34 countries (healthy individuals and those with Alzheimer’s disease, frontotemporal lobar degeneration or mild cognitive impairment). Exposome effects were assessed using generalized additive models and meta-analytic frameworks. Aggregated exposome models explained up to 15.5-fold more variance than individual exposures (delta Akaike information criterion (ΔAIC): 2,034–3,127). Physical exposome was primarily associated with accelerated structural brain aging (limbic, subcortical and cerebellar regions), whereas social exposome was more strongly associated with functional brain aging (frontotemporal and limbic networks). Exposome burden accounted for 3.3−9.1-fold higher risk of accelerated aging, exceeding effects of clinical diagnoses. Findings were out-of-sample validated in cross-sectional and longitudinal designs, remained consistent across clinical subgroups and persisted after adjustment for demographics, age correction bias, cognition, scanner type and data quality. The exposome accelerates brain aging in health and disease, underscoring the need to address physical, social and political inequities.
dc.description.embargo2026-10-02
dc.identifier.citationNature Medicine (2026) p. 1-39
dc.identifier.doihttps://doi.org/10.1038/s41591-026-04302-z
dc.identifier.issn1078-8956
dc.identifier.issne1546-170X
dc.identifier.orcidhttps://orcid.org/0000-0002-7304-5256
dc.identifier.urihttps://hdl.handle.net/20.500.12254/7548
dc.language.isoen
dc.publisherSpringer Nature
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.titleThe exposome of brain aging across 34 countries
dc.typeArticle
dcterms.accessRightsArtículo con embargo
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