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Resilience and brain health in global populations

Nature Medicine volume 31, pages 2518–2531 (2025)Cite this article

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Abstract

Resilience is a multifaceted concept that spans biological, psychological and social domains, and is critical for population health—particularly brain health. While most existing research originates from the global north, there is an urgent need to explore resilience in the majority world settings, where unique biological, exposomal, economic and sociocultural factors shape health. In this Review, we highlight resilience as a key modifier of brain health outcomes. We explore the biological correlates of resilience and the influence of the exposome. We propose future synergistic integrations of exposome, cultural reserve, community resilience, allostasis and whole-body health principles to promote an inclusive perspective in diverse settings. This approach is particularly relevant for majority world contexts, where resource constraints and cultural diversity demand adaptive, scalable and context-sensitive strategies. We discuss measurement approaches and operationalization strategies and, finally, we identify key priorities for future research and policy strategies, with an emphasis on local relevance, equity and sustainability.

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Fig. 1: Resilience model and factors.
Fig. 2: The allostatic interoceptive system and brain–body–environment loops.

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Acknowledgements

We thank C. Ajalo and L. Neufeld for administrative support. Research by C.T.U.-M. and K.B. is supported by funding from The UKRI MRC/MR/Y019822/122, Wellcome Leap Dynamic Resilience Award (co-funded by Temasek Trust), the Alzheimer’s Association (SAGA23-1141999), Global Brain Health Institute (UFRA-424|CA-0241758) and the Davos Alzheimer’s Collaborative Global Cohorts Fund. C.T.U.-M. is additionally funded by The Office for Veterans’ Affairs UK Defense and Security Accelerator (DASA) Fund (G2-SCH-2022-11-12245) and National Institutes of Aging at the National Institutes of Health (RO1-AG074562). A.I. is supported by grants from the multi-partner consortium to expand dementia research in Latin America (ReDLat, supported by Fogarty International Center (FIC), National Institutes of Aging at the National Institutes of Health (R01 numbers AG075775, AG057234, AG082056 and AG083799; CARDS-NIH 75N95022C00031), Alzheimer’s Association (SG-20-725707), Rainwater Charitable Foundation – The Bluefield project to cure FTD, and Global Brain Health Institute)), ANID/FONDECYT Regular (1250091, 1210195, 1210176 and 1220995), ANID/PIA/ANILLOS ACT210096, FONDEF ID20I10152 and ANID/FONDAP 15150012. The contents of this publication are solely the responsibility of the authors and do not represent the official views of these institutions.

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Authors and Affiliations

  1. Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Chinedu T. Udeh-Momoh & Michelle M. Mielke

  2. Brain and Mind Institute, Aga Khan University, Nairobi, Kenya

    Chinedu T. Udeh-Momoh & Karen Blackmon

  3. Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden

    Chinedu T. Udeh-Momoh

  4. Sheffield Institute for Translational Neuroscience, Sheffield University, Sheffield, UK

    Chinedu T. Udeh-Momoh

  5. Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez (UAI), Santiago, Chile

    Joaquin Migeot, Margherita Melloni & Agustin Ibanez

  6. Global Brain Health Institute (GBHI), University of California, San Francisco, CA, USA

    Joaquin Migeot, Hernando Santamaria-Garcia & Agustin Ibanez

  7. Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland

    Joaquin Migeot, Hernando Santamaria-Garcia & Agustin Ibanez

  8. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Karen Blackmon

  9. Department of Biochemistry, University of Oxford, Oxford, UK

    Lynne Cox

  10. Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA

    Kristine Yaffe

  11. Hospital Universitario San Ignacio, Center for Brain and Cognition Intellectus, Pontificia Universidad Javeriana, Bogotá, Colombia

    Hernando Santamaria-Garcia

  12. Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Yaakov Stern

  13. Cognitive Neuroscience Center (UdeSA), Universidad de San Andrés, Buenos Aires, Argentina

    Agustin Ibanez

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  1. Chinedu T. Udeh-Momoh
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Udeh-Momoh, C.T., Migeot, J., Blackmon, K. et al. Resilience and brain health in global populations. Nat Med 31, 2518–2531 (2025). https://doi.org/10.1038/s41591-025-03846-w

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