Understanding what circumstances put people at risk for dementia — and how people
with dementia can thrive — is important to us all.
Throughout life, experiences and the environment impact health and the risk of developing dementia. This is the dementia exposome.
Measuring and understanding these factors is complicated — that’s where the GECC comes in.
The Gateway Exposome Coordinating Center (GECC) advances research on the various environmental exposures over the life course — known as the “exposome” — that affect Alzheimer’s Disease (AD) and AD-Related Dementias (ADRD) risk, resilience, and disparities. Currently, accessing and sharing exposome data among government agencies, researchers, advocacy groups, and businesses is challenging. The GECC aims to address these issues by facilitating collaboration and consensus-building across disciplines, and serving as a hub for collecting, organizing, and sharing exposome data for AD/ADRD research. We concentrate on six main domains: climate, physical environment, social environment, policy environment, community services environment, and life experiences. By creating a collaborative platform across these focuses, we help improve knowledge and understanding of AD/ADRD, which can drive policy changes and provide better data for future research. The GECC is funded by the National Institute on Aging. Our interdisciplinary team is based at the Center for Economic and Social Research, the University of Southern California and partner institutions around the world.
University of Southern California
University of Michigan School of Public Health
University of Southern California
Center Coordinator
University of Southern California
Communications Coordinator
University of Southern California
Policy and Community Services Environment Domain Coordinator
University of Southern California
Life Experiences Domain Coordinator
University of Southern California
Climate, Physical, and Social Environment Domain Coordinator
University of Michigan School of Public Health
Climate Domain Lead
Boston University
Physical Environment Domain Co-Lead
University of Toronto
Physical Environment Domain Co-Lead
University of British Columbia
Social Environment Domain Lead
University of Michigan
Policy Domain Lead
University of Lausanne
Community Services Domain Co-Lead
University of Michigan
Community Services Domain Co-Lead
University of Minnesota
Life Experiences Domain Co-Lead
University of Minnesota
Life Experiences Domain Co-Lead
University of Southern California
Methods Lead
University of Southern California
IT Director
University of Southern California
Dissemination Co-Lead
NYU Grossman School of Medicine
Dissemination Co-Lead
NYU Grossman School of Medicine
Colorado State University
University of Southern California
Boston University
University of Minnesota
Boston University
Boston University
Boston University
Boston University
McGill University
University of Lausanne
NYU Grossman School of Medicine
To achieve these aims and advance life-course research on the AD/ADRD exposome, the GECC serves as a centralized hub for accessing, harmonizing, linking, and sharing exposome data for AD/ADRD researchers across disciplines, with a focus on six key, interconnected domains:
Climate
Physical Environment
Social Environment
Policy Environment
Community Services Environment
Life Experiences
Methods
Dissemination
Although each domain has unique goals and outputs, all domains advance AD/ADRD exposome research in their fields by inclusively and transparently establishing consensus on high priority research topics, developing standards for data collection, and carrying out novel data collection for key exposome measures.
Advancements in each domain will drive ongoing cooperative efforts. Domain experts and the core teams will continue to meet regularly to discuss progress towards these goals and share their findings. The GECC will host additional town halls, workshops, and expert panels to publicize and circulate new domain-specific knowledge, improved measures, and enhanced policies for exposome data collection and sharing.
Given the diversity of environmental exposures over the life course, cross-disciplinary collaboration and expertise is critical. The GECC focuses on six key, interconnected domains: climate, physical environment, social environment, policy environment, community services environment, and life experiences, as well as two core teams dedicated to methodological issues and dissemination.
Climate
The climate domain considers the impacts of a wide range of relevant hazards on healthy aging, including rising outdoor temperatures and risks posed by smoke from wildfires, flooding, episodes of extreme heat, and other extreme weather events. This is an important area of focus since the climate is rapidly changing and weather events have been associated with higher rates of death and healthcare utilization among the general population, but especially those with dementia. Older adults with poorer cognition are particularly vulnerable to extreme weather events and stressors since they are often less mobile, are on a fixed income, may be taking medications that interfere with thermoregulation, and have chronic diseases. Climate hazards can vary dramatically across individuals for reasons including age, occupation, and living conditions. Therefore, activities focused on climate change mitigation, adaptation, and resilience can profoundly impact the health of people with cognitive declines and dementia. The Climate domain is led by Dr. Gregory Wellenius (Boston University).
Physical
Environment
The natural and built environment where we live, work, exercise, and socialize can have important influences on health. Some features of the physical environment can be harmful to health like air pollution and noise. Yet, other aspects like visibility of trees and lakes or access to transportation, parks, benches, restrooms, and safe communities can improve health. Since much of the physical environment can be modified, this is a critical area of importance to reduce the risks of dementia or improve the well-being of those with dementia. The Physical Environment domain is co-led by Dr. Jeffrey Brook (University of Toronto) and Dr. Michael Brauer (University of British Columbia).
Policy
Environment
The policy domain covers a broad scope of government policies that influence key determinants of AD/ADRD outcomes throughout life. This may include public health policies targeting dementia prevention (e.g., tobacco and alcohol control policies, nutritional labelling and food policies, urban design and walkability policies); health and long-term care policies (e.g., home-based care programs, institutional long-term care, caregiving support policies, end-of-life and palliative care policies); physical environmental policy (e.g., air quality and pollution control, noise pollution reduction, access to green spaces), and social policies (e.g., education policy, employment and workplace policies, social inclusion policies, income security and protection). Given this wide range of influential policies, variations across jurisdictions and time periods serve as natural experiments, allowing researchers to study how different policies affect AD/ADRD risk factors, and ultimately informing more targeted and effective interventions. To make progress in this domain, the GECC focuses on three main aims: reaching consensus on key policies affecting AD/ADRD outcomes, developing standardized methods for policy data collection, and creating robust analytical approaches to examine policy variations across temporal and spatial dimensions. The Policy Environment domain is led by Prof. Mauricio Avendano (University of Lausanne).
Community Services
Environment
The community services domain focuses on care and support systems, including healthcare, long-term care, senior services, and emergency preparedness. These services significantly influence AD/ADRD risks, care, and resilience for individuals and populations, while also moderating the impacts of other domains. Research in this domain focuses on developing frameworks and innovative methods for measuring the availability and accessibility of diverse services, going beyond mere presence to assess their quality, quantity, and access. This comprehensive approach aims to deepen our understanding of how community services impact AD/ADRD outcomes, providing crucial insights for developing effective interventions to mitigate disparities and improve quality of care. The Community Services Environment domain is co-led by Dr. HwaJung Choi (University of Michigan) and Mr. David Van Riper (University of Minnesota).
Life Experiences
The life experiences domain explores how a range of experiences – from well-studied categories like education and caregiving, to less-studied aspects such as migration, stress and day-to-day experiences – shape health and well-being across the lifespan and relate to AD/ADRD outcomes. Primarily focused on individual and family level experiences, this domain employs novel approaches to understanding these occurrences across space and time. For example, time-related research in this domain examines how the cumulative effects of life experiences differ from isolated risk factors, takes into account how certain experiences have different impacts over time, and considers how the duration of an important life experience or when it occurs in the life course changes its import. This domain also intersects with the social environment, policy landscape, and community services domains to provide a holistic understanding of how various life experiences influence health and wellbeing as individuals and populations age. The Life Experiences domain is co-led by Dr. Sarah Flood (University of Minnesota) and Dr. Shrikanth Narayanan (University of Southern California).
MethodsThe methods core tackles cross-domain methodological challenges focused on measuring exposures and their associations with AD/ADRD outcomes. Topics of interest to the methods group include methods and approaches for summarizing and analyzing high-dimensional and complex exposome data, including index construction methods, the application of mixture methods to jointly model combinations of exposures, and the use of machine learning methods to capture complex interplay between different exposome components. The group will also tackle challenges related to consideration of life course data on exposures from birth and early childhood to late life, developing and discussing common approaches to understand and evaluate sensitive periods and cumulative exposures across time. Additionally, the methods core will consider topics focused on minimizing bias in causal analyses of the exposome and AD/ADRD outcomes, including the incorporation and consideration of measurement error, selection bias in studies of older adults, and evidence triangulation and synthesis. By tackling high-priority challenges relevant to multiple domains, the methods core will provide crucial insights to guide measure construction and subsequent analytic projects across the coordinating center. The methods core is led by Dr. Emma Nichols (University of Southern California).
Dissemination
The dissemination team leverages and expands an existing network of outreach partners to distribute GECC-developed resources to a diverse array of AD/ADRD stakeholders. Collaborating with different domains, the team will produce, publish, and publicize materials like research briefs, infographics, and lay summaries of GECC activities. These resources will be crafted for clarity and accessibility, catering to the needs of both policymakers and researchers in adjacent disciplines. The dissemination core is co-led by Dr. Lorna Thorpe (NYU Grossman School of Medicine) and Dr. Marc Gourevitch (NYU Grossman School of Medicine).
Thank you to those who have already attended a GECC town hall!
In the fall of 2024, the GECC hosted a series of town hall meetings with 293 unique participants representing 133 organizations across 21 countries. These meetings yielded critical insights that will steer the GECC’s future efforts, helping to prioritize research areas, create new resources, and develop tools that will support the broader research community to gain a better understanding of the exposome and its impact on brain health.
The GECC’s first town hall meetings on October 9th were a resounding success, bringing together 127 participants from 64 organizations across 13 countries to generate insights on the influences of brain health as people.
Participants discussed themes including:
The November town halls brought together 129 participants from 60 organizations across 12 countries.
Participants discussed the following topics:
The final set of town hall meetings for the year had 113 participants from 55 organizations across 10 countries.
Participants discussed the following topics:
The town halls allowed participants the opportunity to discuss what is most important to them. Hosted virtually on Zoom, participants began by suggesting key factors that may influence our communities’ risk of, resilience to, and disparities in Alzheimer’s and dementia. Breakout sessions then formed around these topics for participants to have focused discussions. Collaborative notes were taken so that these discussions will help guide participants and the GECC to set priorities for future scientific research and policies related to brain health.
The GECC will host another round of town hall meetings in 2027 to review progress on our initial priorities and identify any new priorities that have arisen in the interim.
Read about the latest updates, releases, and announcements from the GECC.
The GECC’s first town hall meeting on October 9th was a resounding success, bringing together 127 participants from 64 organizations across 13 countries to generate insights on the influences of brain health.
Participants discussed themes including:
Feedback from participants will directly inform the GECC’s future efforts, helping us prioritize research areas, create new resources, and develop tools that will benefit the broader community.
To engage with the GECC’s future activity be sure to:
Register for our future town hallsThe ambitious project will study influences on dementia risk and resilience as varied as pollution, education and policy.
Backed by a $25 million, five-year federal grant from the National Institute on Aging, USC’s Center for Economic and Social Research (CESR) is launching an ambitious investigation into the complex matrix of factors that feed into developing — or being protected from — Alzheimer’s and other related forms of dementia.
This matrix, or “exposome,” refers to all environmental exposures and corresponding biological responses experienced by an individual throughout his or her life.
Exposome research examines risk and resilience influences as varied as pollution, education or policy, with the goal of understanding how resulting biological changes may lead to disease. For example, previous research at USC has shown that exposure to fine-particle pollution, or PM2.5, leads to Alzheimer’s-like brain changes in humans. Other research shows how education may improve the brain’s ability to withstand damage that leads to dementia.
Understanding Alzheimer’s “exposome” is “increasingly urgent”
“Understanding how these exposures impact health and contribute to Alzheimer’s disease is increasingly urgent as the global population ages,” said principal investigator Jinkook Lee, director of the program on global aging, health and policy at CESR. CESR is based at the USC Dornsife College of Letters, Arts and Sciences.
Lee’s project, known as the Gateway Exposome Coordinating Center (GECC), will spearhead development of enhanced data and collaboration across disciplines to identify which aspects of the exposome affect dementia risk and how these can be mitigated.
“This center is an excellent exemplar that interconnects several of USC’s ‘moonshots’ — from health and computing to sustainability. This center further expands on other efforts of this team on the global stage such as the Longitudinal Aging Study in India, another USC priority,” said Shrikanth “Shri” Narayanan, vice president for presidential initiatives at USC.
“Efforts such as Lee’s exposome project have positioned USC at the top of U.S. universities in National Institutes of Health neuroscience awards,” said Ishwar K. Puri, senior vice president of USC’s Office of Research and Innovation. “With cutting-edge international collaborations and four prominent research centers, we believe we can get out in front of Alzheimer’s and prevent or stall the disease.”
The GECC’s efforts will bring together leading researchers from USC and other institutions, alongside key government agencies such as the Department of Health and Human Services, the National Institutes of Health and the Environmental Protection Agency. This interdisciplinary collaboration is crucial for identifying priority areas and shaping future research in the field, Lee said.
“Collaboration is a cornerstone of the GECC,” said David Knapp, a senior economist at CESR who is co-leading the project with Lee and Sara Adar from the University of Michigan. “We are fostering consensus-building among researchers and stakeholders from diverse fields, ensuring a broad, inclusive approach to understanding the exposome’s role in dementia.”
Expanding long-running data project
The GECC project is an expansion of the Gateway to Global Aging Data, a long-running project with $24.7 million federal grant from the National Institute on Aging. The Gateway to Global Aging Data is a public resource for longitudinal and cross-national studies on aging over 42 countries around the world, offering data, information and tools to stimulate global aging research.
The GECC project joins another recently launched, large-scale collaboration on Alzheimer’s and dementia that is also anchored at USC.
Julie Zissimopoulos, a professor at the USC Price School of Public Policy and the USC Schaeffer Center for Health Policy & Economics, is leading an effort to build a dementia cost model that will generate comprehensive national, annual estimates of the cost of dementia. The project, funded by an $8.2 million grant from the National Institute on Aging, could benefit patients and their families.
To contact us, email us at: contact@gatewayexposome.org
Contact us at contact@gatewayexposome.org
The social environment includes a person's workplace, neighborhood, society, and groups to which they belong. It can be characterized by how people relate to each other and the structures of the community. Features of social processes include things like social connections, support networks, and trust among people. Structural features refer to aspects of a place like racial segregation of where people live, housing affordability, and the overall wealth of a neighborhood. Many of these factors are linked to health conditions associated with dementia like hypertension and cardiovascular diseases, but more research is needed to understand how they affect brain health. The Social Environment domain is led by Dr. Maggie Hicken (University of Michigan).