The physical and social exposome in brain health and dementia across the lifespan

Social and physical exposome factors (e.g., nutrition, poverty, education, discrimination, abuse, infections, toxins, pollution, structural inequality) accumulate across development and adulthood, shaping biological and clinical outcomes. These exposures become biologically embedded through pathways including systemic inflammation, telomere attrition, cognitive decline, accelerated aging, and whole-body health impairments. Such processes contribute to functional decline, neuropsychiatric symptoms, subjective cognitive decline, mild cognitive impairment, and ultimately dementia. Methodological approaches—such as longitudinal designs, standardized exposome/adversity measures, brain modeling, exposome–omics integration, and probabilistic inference models are required to capture the complexity of these dynamics.