{ "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.", "abstract_shown": true, "affiliations": [ "Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.", "Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.", "Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, USA.", "Keck School of Medicine, University of Southern California, Los Angeles, California, USA.", "Kessler Foundation, West Orange, New Jersey, USA.", "Department of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.", "Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA.", "Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.", "Departments of Psychiatry, Neurology, and Population Health, NYU Grossman School of Medicine, New York University, New York, New York, USA.", "Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.", "Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands.", "Department of Neurology and Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China.", "Department of Public Health Sciences, University of California Davis, Davis, California, USA.", "Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, Arizona, USA.", "Edward and Pearl Fein Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.", "Virginia Geriatric Education Center, Virginia Center on Aging, Virginia Commonwealth University, Richmond, Virginia, USA.", "School of Public Health, George Mason University, Fairfax, Virginia, USA.", "University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.", "Department of Behavioral Health, Brooke Army Medical Center, San Antonio, Texas, USA.", "Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.", "Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.", "Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA.", "Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University Health Science Center, Kingsville, Texas, USA.", "Hopkins Economics of Alzheimer's Disease and Services Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.", "School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA.", "Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA." ], "article_type": "review article", "arxiv": null, "author_total": 23, "authors": [ { "affs": [ 0 ], "name": "Ganga S Bey", "orcid": "0000-0002-9659-7096" }, { "affs": [ 1 ], "name": "Sheina Emrani" }, { "affs": [ 2 ], "name": "Erin R Kulick" }, { "affs": [ 3, 4 ], "name": "Cristina A F Román" }, { "affs": [ 5 ], "name": "Ileana De Anda-Duran" }, { "affs": [ 6 ], "name": "Miriam T Ashford" }, { "affs": [ 7 ], "name": "Rory Boyle" }, { "affs": [ 8 ], "name": "Omonigho Michael Bubu" }, { "affs": [ 9 ], "name": "Jasmine Dixon" }, { "affs": [ 10 ], "name": "Sanne Franzen" }, { "affs": [ 11 ], "name": "Pei-Yang Gao" }, { "affs": [ 12 ], "name": "Kristen George" }, { "affs": [ 13 ], "name": "M Aaron Guest" }, { "affs": [ 14 ], "name": "Margo B Heston" }, { "affs": [ 15, 16, 17 ], "name": "Patricia Heyn", "orcid": "0000-0002-9015-362X" }, { "affs": [ 18 ], "name": "Daija Jackson" }, { "affs": [ 19 ], "name": "Sudarshan Krishnamurthy" }, { "affs": [ 7 ], "name": "Jeffrey S Phillips" }, { "affs": [ 10 ], "name": "Awaale F Rirash" }, { "affs": [ 20, 21 ], "name": "Jayalakshmi Viswanathan", "orcid": "0000-0001-5338-3170" }, { "affs": [ 22, 23 ], "name": "Preeti Pushpalata Zanwar" }, { "affs": [ 24, 25 ], "name": "Megan Zuelsdorff" }, { "affs": [ 1 ], "name": "Shana D Stites", "orcid": "0000-0003-3994-4343" } ], "bibtex": "https://research.draconitic.com/paper/25a64j1cwv0pa.bib", "cited_by": 0, "doi": "10.1002/alz.71957", "fulltext_url": "https://europepmc.org/articles/PMC13751840", "id": "25a64j1cwv0pa", "issns": [ "1552-5260", "1552-5279" ], "landing_url": "https://europepmc.org/article/MED/43010124", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "3600|Health Policy Implementation Science" ] ], "openalex": "W7225805633", "pdf_url": "https://europepmc.org/articles/PMC13751840?pdf=render", "pmcid": "PMC13751840", "pmid": "43010124", "published": "2026-11-01", "publisher": null, "ris": "https://research.draconitic.com/paper/25a64j1cwv0pa.ris", "sources": [ { "first_seen": "2026-11-12T15:21:48Z", "native_id": "MED:43010124", "source": "europepmc", "url": "https://europepmc.org/article/MED/43010124" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Lifestyle interventions on Alzheimer's disease and related dementias: Social and structural determinants of implementation effectiveness and sustainability.", "title_text": "Lifestyle interventions on Alzheimer's disease and related dementias: Social and structural determinants of implementation effectiveness and sustainability.", "type": "peer-reviewed", "updated_at": "2026-11-13T03:20:44Z", "url": "https://research.draconitic.com/paper/25a64j1cwv0pa", "venue": "Alzheimer's & dementia : the journal of the Alzheimer's Association", "versions": [] }