The Population Neuroscience-Dementia Syndemics Framework to better understand global sex and gender-based risk in low- and middle-income countries

Globally, the burden of dementia profoundly affects low- and middle-income countries (LMICs), with a greater burden and risk for late-life women than men. Structural and social determinants of health, crucial constructs conferring risk and protection from later-life dementia, are relatively understudied, yet essential in LMICs. Typical neuroscience studies have historically been small, with highly selected samples that do not generalize well to target populations in LMICs. To better understand gender and sex differences in dementia risk in LMICs, this Perspective lays out a guiding framework for a global dementia research plan—the Population Neuroscience-Dementia Syndemics Framework. Population neuroscience considers the brain in a multilevel context, from a lifecourse perspective, using tools to enhance internal and external validity, while syndemics suggest that diseases and social conditions may cluster and interact in populations with syndemic risk factors—sociocultural, political, economic, and environmental factors that promote stress pathways and disease. This Perspective proposes the Population Neuroscience-Dementia Syndemics Framework and model to develop knowledge of how multiple factors may interact to perpetuate inequities in dementia, especially for women in low- and middle-income countries.