{"doi":"10.1002/ctm2.1486","title":"Global South research is critical for understanding brain health, ageing and dementia","abstract":"Brain health, ageing and dementia are influenced by various heterogeneous factors, which do not exhibit universal applicability across diverse contexts.1-8 Variability in genetics, pathophysiological pathways, clinical presentations, aetiology and exposome is non-homogeneous across geographical regions.2, 9 Additionally, unequal epidemiological patterns related to risk and protective factors, social determinants of health (SDH), socioeconomic disparities and healthcare access play important roles in brain health.1, 9 Thus, brain-phenotype models developed in more homogenous populations from the Global North may misrepresent the characteristics of more diverse populations.2, 3 Despite the urgent need to explore regional diversity and provide tailored recommendations, a noticeable research imbalance across regions persists.3, 10 Paradoxically, most research has been conducted in high-income settings within the United States and Europe, often overlooking the diverse and non-stereotypical populations in the Global South. The impact of high levels of disparities on brain health and ageing in underserved populations is evident across various aspects, including risk factors, brain dynamics, functionality, cognition, biomarkers, neurodegeneration, allostatic overload and access to novel therapeutic targets.1, 6, 7, 11, 12 Social and environmental disparities, such as low education, elevated poverty rates and heightened exposure to adversity, increase the prevalence of chronic conditions associated with brain health and dementia risks.13 For instance, metabolic disorders such as Type-2 diabetes mellitus, cardiovascular disease and cerebrovascular disease are more prevalent among underserved populations.13, 14 We recently found1 that health disparities and SDH, such as education, cardiometabolic conditions and social isolation, severely influence the healthy ageing of Latin American populations, impacting cognition and functional ability more than traditional factors like age and gender. This heterogeneity in risk factors was particularly pronounced in lower- to middle-income countries (Colombia and Ecuador). In addition, while educational attainment predicts cognitive performance in older adults from homogeneous populations,13, 15 this relationship weakens among heterogeneous groups due to disparities in access to high-quality education. Altogether, these findings emphasise the significant influence of disparities and region-specific factors on brain health and ageing. These effects seem to be more accentuated across Global South populations, evidencing the inadequacy of a one-size-fits-all approach. Similarly, population diversity and disparity have a strong effect on dementia.8, 11, 13, 16 North Africa/Middle East (8.7%) and Latin America (8.4%) exhibit the current highest dementia prevalence, with Central Europe having the lowest one (4.7%).17 The larger prevalence in the Global South is associated with health and socioeconomic disparities.8, 11 Diversity and disparities are also evident in the projected increases in the number of people living with dementia in 2050, with the most significant percentage changes in North Africa and the Middle East (367%) and the smallest in Western Europe (74%).17 Additionally, dementia genetic risk factors, such as the apolipoprotein (APOE) 4 allele, the most significant ged8netic risk factor for Alzheimer's disease (AD), seem to differ across populations. This allele is more frequent among individuals with African ancestry but has an attenuated association with AD risk, compared to those of European ancestry.18 The influence of diversity and disparity is further evident in marked inequalities in care-seeking and dementia diagnosis among the Global South. For example, in many low- and middle-income countries, the diagnosis of dementia often occurs at a more advanced stage due to low societal awareness, compared to Western countries.2 The caregiver burden is increased in Latin America, compared to ot","journal":"Clinical and Translational Medicine","year":2023,"id":320891,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":47,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9551,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1032249,"name":"Suvarna Alladi","orcid":"0000-0002-0372-9572","position":1,"is_corresponding":false},{"id":282310,"name":"Agustín Ibáñez","orcid":"0000-0001-6758-5101","position":2,"is_corresponding":false},{"id":233799,"name":"Sandra Báez","orcid":"0000-0003-0875-1709","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-19T01:07:27.434133Z","pmid":"37987144","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}