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Siette J, Meka A, Antoniades J. Breaking the barriers: overcoming dementia-related stigma in minority communities. Front Psychiatry 2023; 14:1278944. [PMID: 38179250 PMCID: PMC10765564 DOI: 10.3389/fpsyt.2023.1278944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Dementia is a global health concern that affects individuals irrespective of their cultural or linguistic backgrounds. However, research has long recognized the pronounced stigma associated with dementia, particularly within Culturally and Linguistically Diverse (CALD) communities. This article seeks to summarize the underlying factors contributing to the heightened levels of dementia stigma within CALD communities, through a review of the literature. Our examination shows that cultural beliefs, language barriers, limited awareness, and the impact of migration on perceptions of aging and cognitive decline are contributing factors. Consequently, our analysis highlights the need for tailored, culturally appropriate interventions aimed at mitigating stigma and enhancing dementia care within CALD populations. Our proposed solutions, built on a social-ecological approach, highlights the critical role of collaborative efforts involving policymakers, healthcare providers, community organizations, and CALD community members in fostering a more dementia-inclusive society. This perspective piece aims to shed light on the distinct challenges faced by CALD communities, while advocating for a holistic approach to redefine perceptions and care strategies tailored to these populations.
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Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
- Australian Institute for Health Innovation, Macquarie University, Macquarie Park, NSW, Australia
| | - Anjani Meka
- Australian Institute for Health Innovation, Macquarie University, Macquarie Park, NSW, Australia
| | - Josefine Antoniades
- National Ageing Research Institute, Affiliate Global and Women’s Health, School of Public Health and Preventive Medicine, Monash University, Royal Melbourne Hospital, Parkville, VIC, Australia
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Fitri FI, Lage C, Mollayeva T, Santamaria-Garcia H, Chan M, Cominetti MR, Daria T, Fallon G, Gately D, Gichu M, Giménez S, Zuniga RG, Hadad R, Hill-Jarrett T, O’Kelly M, Martinez L, Modjaji P, Ngcobo N, Nowak R, Ogbuagu C, Roche M, Aguzzoli CS, Shin SY, Smith E, Yoseph SA, Zewde Y, Ayhan Y. Empathy as a crucial skill in disrupting disparities in global brain health. Front Neurol 2023; 14:1189143. [PMID: 38162446 PMCID: PMC10756064 DOI: 10.3389/fneur.2023.1189143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/26/2023] [Indexed: 01/03/2024] Open
Abstract
Brain health refers to the state of a person's brain function across various domains, including cognitive, behavioral and motor functions. Healthy brains are associated with better individual health, increased creativity, and enhanced productivity. A person's brain health is intricately connected to personal, social and environmental factors. Racial, ethnic, and social disparities affect brain health and on the global scale these disparities within and between regions present a hurdle to brain health. To overcome global disparities, greater collaboration between practitioners and healthcare providers and the people they serve is essential. This requires cultural humility driven by empathy. Empathy is a core prosocial value, a cognitive-emotional skill that helps us understand ourselves and others. This position paper aims to provide an overview of the vital roles of empathy, cooperation, and interdisciplinary partnerships. By consciously integrating this understanding in practice, leaders can better position themselves to address the diverse challenges faced by communities, promote inclusivity in policies and practices, and further more equitable solutions to the problem of global brain health.
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Affiliation(s)
- Fasihah Irfani Fitri
- Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
| | - Carmen Lage
- Department of Neurology, Marques de Valdecilla University Hospital - Valdecilla Research Institute (IDIVAL), Santander, Spain
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
| | - Tatyana Mollayeva
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Canada Research Chairs, Ottawa, ON, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hernando Santamaria-Garcia
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, Bogotá, Colombia
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, Bogotá, Colombia
| | - Melissa Chan
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Department of Social Sciences, University of Luxembourg, Luxembourg, Luxembourg
| | - Marcia R. Cominetti
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Tselmen Daria
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Gladstone Institutes, San Francisco, CA, United States
| | - Gillian Fallon
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
| | - Dominic Gately
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
| | - Muthoni Gichu
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Division of Geriatric Medicine at the Ministry of Health, Nairobi, Kenya
| | - Sandra Giménez
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Multidisciplinary Sleep Unit, Memory Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raquel Gutierrez Zuniga
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Hospital Quirónsalud Valle del Henares, Madrid, Spain
| | - Rafi Hadad
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Rambam Health Care Campus, Haifa, Israel
| | - Tanisha Hill-Jarrett
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Memory and Aging Center, Medical Center, University of California, San Francisco, CA, United States
| | - Mick O’Kelly
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- National College of Art and Design, Dublin, Ireland
| | - Luis Martinez
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Memory and Aging Center, Medical Center, University of California, San Francisco, CA, United States
| | - Paul Modjaji
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
| | - Ntkozo Ngcobo
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Department of Psychiatry, University of KwaZulu-Natal, Durban, South Africa
| | - Rafal Nowak
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Neuroelectrics (Spain), Barcelona, Spain
| | - Chukwuanugo Ogbuagu
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Faculty of Basic Clinical Sciences, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Moïse Roche
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, Dublin, Ireland
- Division of Psychiatry, UCL, London, United Kingdom
| | - Cristiano Schaffer Aguzzoli
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - So Young Shin
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- College of Nursing, Inje University, Busan, Republic of Korea
| | - Erin Smith
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Stanford University, Stanford, CA, United States
| | - Selam Aberra Yoseph
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yared Zewde
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yavuz Ayhan
- Senior Atlantic Fellow at the Global Brain Health Institute/Trinity College, UCSF, San Francisco, CA, United States
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Santamaria-Garcia H, Sainz-Ballesteros A, Hernandez H, Moguilner S, Maito M, Ochoa-Rosales C, Corley M, Valcour V, Miranda JJ, Lawlor B, Ibanez A. Factors associated with healthy aging in Latin American populations. Nat Med 2023; 29:2248-2258. [PMID: 37563242 PMCID: PMC10504086 DOI: 10.1038/s41591-023-02495-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/11/2023] [Indexed: 08/12/2023]
Abstract
Latin American populations may present patterns of sociodemographic, ethnic and cultural diversity that can defy current universal models of healthy aging. The potential combination of risk factors that influence aging across populations in Latin American and Caribbean (LAC) countries is unknown. Compared to other regions where classical factors such as age and sex drive healthy aging, higher disparity-related factors and between-country variability could influence healthy aging in LAC countries. We investigated the combined impact of social determinants of health (SDH), lifestyle factors, cardiometabolic factors, mental health symptoms and demographics (age, sex) on healthy aging (cognition and functional ability) across LAC countries with different levels of socioeconomic development using cross-sectional and longitudinal machine learning models (n = 44,394 participants). Risk factors associated with social and health disparities, including SDH (β > 0.3), mental health (β > 0.6) and cardiometabolic risks (β > 0.22), significantly influenced healthy aging more than age and sex (with null or smaller effects: β < 0.2). These heterogeneous patterns were more pronounced in low-income to middle-income LAC countries compared to high-income LAC countries (cross-sectional comparisons), and in an upper-income to middle-income LAC country, Costa Rica, compared to China, a non-upper-income to middle-income LAC country (longitudinal comparisons). These inequity-associated and region-specific patterns inform national risk assessments of healthy aging in LAC countries and regionally tailored public health interventions.
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Affiliation(s)
- Hernando Santamaria-Garcia
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
- Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia.
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia.
| | | | - Hernán Hernandez
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Faculty of Engineering, University of Concepción, Concepción, Chile
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés and Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Marcelo Maito
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Carolina Ochoa-Rosales
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Michael Corley
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA
| | - Victor Valcour
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Memory and Aging Center, University California San Francisco, San Francisco, CA, USA
| | - J Jaime Miranda
- Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Brian Lawlor
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Agustin Ibanez
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile.
- Cognitive Neuroscience Center, Universidad de San Andrés and Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
- Trinity College Dublin, The University of Dublin, Dublin, Ireland.
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