The deprivation cascade hypothesis of dementia

Abstract

There are significant disparities in dementia risk and care burden in the global population. This review provides evidence of the effects of deprivation, understood as the absence of environmental resources required for brain health. Deprivation increases dementia risk and care burden due to biological, environmental, and social dimensions of risk. It is hypothesized that the major mediator between deprivation and dementia is reduced educational and professional attainment. It argues for structural interventions centered around improved attainment, particularly for girls and women across the globe, improved funding for primary and social care, and a rights-based approach to brain health to improve access to these resources and thereby reduce dementia disparities.