Lifestyle interventions on Alzheimer's disease and related dementias: Social and structural determinants of implementation effectiveness and sustainability
Year: 2026
Type: review
Abstract: Alzheimer's disease and related dementias (ADRD) pose a global public health challenge, and epidemiological evidence underscores profound disparities in ADRD risk and outcomes that are rooted in social/structural determinants of health (S/SDOH). Yet, these determinants are seldom integrated into intervention design or implementation strategies. In this review, we identify S/SDOH that influence the equitable implementation of evidence-based ADRD lifestyle interventions across diverse groups and explore implications. Guided by Bronfenbrenner's ecological model, we: (1) examined theoretical foundations, focusing on how macrosystem and microsystem factors modulate implementation effectiveness across multiple intervention modalities; (2) synthesized empirical literature, highlighting successful and suboptimal intervention outcomes in marginalized populations; (3) identified critical gaps, especially where evidence on implementation across socially defined groups is lacking; and (4) discussed implications for enhancing design and policy for equitable ADRD intervention delivery. Our goal is to produce a conceptual and empirical synthesis that offers actionable guidance for clinicians, researchers, and policy makers.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.71957
Authors: Ganga S. Bey, Sheina Emrani, Erin R. Kulick, Cristina A. F. Román, Ileana De Anda‐Duran, Miriam T. Ashford, Rory Boyle, Omonigho Michael Bubu, Jasmine Dixon, Sanne Franzen, Pei‐Yang Gao, Kristen George, M. Aaron Guest, Margo B. Heston, Patricia Heyn, Daija Jackson, Sudarshan Krishnamurthy, Jeffrey S. Phillips, Awaale F. Rirash, Jayalakshmi Viswanathan, Preeti Pushpalata Zanwar, Megan Zuelsdorff, Shana D. Stites
Institutions: University of North Carolina at Chapel Hill, University of Pennsylvania, Temple University, University of Southern California, Kessler Foundation, Tulane University, University of California, San Francisco, New York University, Brigham and Women's Hospital, Erasmus MC, Capital Medical University, Xuan Wu Hospital of the Capital Medical University, University of California, Davis, Arizona State University, UCSF Edward and Pearl Fein Memory and Aging Center, George Mason University, Virginia Commonwealth University, University of Colorado Anschutz, Virginia Commonwealth University Medical Center, Brooke Army Medical Center, Wake Forest University Health Sciences, Wake Forest University, Indiana University Indianapolis, Indiana University School of Medicine, Johns Hopkins University, Texas A&M University – Kingsville, Texas A&M University, University of Wisconsin–Madison
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7225805633