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A roadmap for conducting more inclusive research on brain resilience in ageing and dementia

Nature Reviews Neuroscience (2026)Cite this article

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Abstract

The variability in cognitive and brain ageing trajectories may be influenced by inter-individual and community-level differences in resilience that result from differential exposures to social and structural determinants of health and be affected by an individual’s sex and gender. However, no clear guidance exists on how to best integrate these diversity-related factors (that is, sex, gender and social and structural determinants of health) into clinical and cognitive neuroscience research on resilience in ageing and dementia. The international Brain Resilience and Diversity in Aging and Dementia (BReDAD) Collaboratory was established in 2024 with the goals of synthesizing knowledge, identifying knowledge gaps and developing recommendations for conducting more inclusive research on resilience in this area. On the basis of a focused review of the literature, and discussions held and recommendations made by the Collaboratory, in this Roadmap article, we present a way forward for integrating diversity in future resilience research. This proposal comprises: (i) developing trust and meaningful long-term relationships with communities historically excluded from research; (ii) diversifying who is engaged in all aspects of the research process; (iii) adopting a life-course perspective; (iv) improving and expanding research designs and measurement tools; and (v) using sensitive computational analytics and mixed methods for testing complex, intersectional models. We conclude by recommending a transdisciplinary approach in resilience research to better reflect the complexities inherent in studying diversity and developing precision medicine outcomes.

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Fig. 1: A roadmap for integrating diversity in research on resilience in ageing and dementia.

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Acknowledgements

The authors thank all attendees at the BReDAD Collaboratory symposium. The BReDAD Collaboratory is funded by the Canadian Institutes of Health Research (CIHR) Institute of Aging Operating Grant: Brain Health and Reduction of Risk for Age-related Cognitive Impairment — Knowledge Synthesis and Mobilization Grants, reference no. 191181 awarded to M.N.R. as the principal investigator (PI), with R.A.D., G.E. and Y.S. as co-PIs. M.N.R. acknowledges support from the Canada Research Chairs Program CRC-2022-00,240, CIHR Sex & Gender Research Chair GS9-171,369, and NSERC Discovery Grant RGPIN-2018-05,761. G.E. acknowledges support from the CIHR no. WJP-150643 (the Wilfred and Joyce Posluns Chair in Women’s Brain Health and Aging), Canadian Cancer Society no. 310336, Alzheimer Society of Canada no. 72953944, CIHR no. MOP-130490, Ontario Brain Institute, CIHR no. CNA-163902 and the Jacqueline Ford Fund for Gender and Health. R.A.D. acknowledges support from the Canadian Consortium on Neurodegeneration in Aging with funding from Alberta Innovates (no. G2020000063) and CIHR (no. 163902).

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Authors and Affiliations

  1. Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada

    M. Natasha Rajah & Jason Deska

  2. Department of Psychiatry, McGill University, Montreal, Québec, Canada

    M. Natasha Rajah

  3. Department of Psychology, University of Alberta, Edmonton, Alberta, Canada

    Roger A. Dixon

  4. Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada

    Roger A. Dixon

  5. Department of Psychology, University of Toronto, Toronto, Ontario, Canada

    Gillian Einstein

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

    Yaakov Stern

  7. Department of Pharmacology and Physiology, Université de Montréal, Montreal, Québec, Canada

    Amanpreet Badhwar

  8. Department of Neurology, Harvard University Medical School, Cambridge, MA, USA

    Rachel Buckley

  9. Department of Psychology, Brock University, St. Catharines, Ontario, Canada

    Karen Campbell

  10. Department of Psychology, McGill University, Montreal, Québec, Canada

    Keita Christophe

  11. Department of Psychology, University of Texas at Austin, Austin, TX, USA

    Audrey Duarte

  12. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

    Liisa Galea

  13. Center for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada

    Liisa Galea

  14. Department of Neurology and Neurosurgery, McGill University, Montreal, Québec, Canada

    Maiya Geddes, Yasser Iturria-Medina, Bratislav Misic & Madeleine Sharp

  15. Knowledge Mobilization Specialist, Canadian Consortium for Neurodegeneration in Aging, Lady Davis Institute for Medical Research, Montréal, Québec, Canada

    Inbal Itzhak

  16. Department of Psychiatry and Addiction, Université de Montréal, Montreal, Québec, Canada

    Robert-Paul Juster

  17. Person with Lived Experience, Alzheimer’s Disease Advocate, Surrey, British Columbia, Canada

    Jim Mann

  18. Center for Vital Longevity, University of Texas at Dallas, Richardson, TX, USA

    Michael Rugg

  19. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Prashanthi Vemuri

Authors
  1. M. Natasha Rajah
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  2. Roger A. Dixon
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  3. Gillian Einstein
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Consortia

The Brain Resilience and Diversity in Aging and Dementia Collaboratory

  • Amanpreet Badhwar
  • , Rachel Buckley
  • , Karen Campbell
  • , Keita Christophe
  • , Roger A. Dixon
  • , Jason Deska
  • , Audrey Duarte
  • , Gillian Einstein
  • , Liisa Galea
  • , Maiya Geddes
  • , Yasser Iturria-Medina
  • , Inbal Itzhak
  • , Robert-Paul Juster
  • , Jim Mann
  • , Bratislav Misic
  • , M. Natasha Rajah
  • , Michael Rugg
  • , Madeleine Sharp
  • , Yaakov Stern
  •  & Prashanthi Vemuri

Contributions

M.N.R., R.A.D., G.E. and Y.S. researched data for the article, provided substantial contributions to discussion of its content, wrote the article and reviewed and edited the manuscript before submission. BReDAD Collaboratory members A.B., R.B., K.C., K.C., J.D., A.D., L.G., M.G., Y.I., I.I., R.J., J.M., B.M., M.R., M.S. and P.V. contributed content for the article and provided substantial input on the discussion of its content.

Corresponding author

Correspondence to M. Natasha Rajah.

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Nature Reviews Neuroscience thanks Carol Brayne, Eero Vuoksimaa and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Related links

Brain Resilience and Diversity in Aging and Dementia (BReDAD) Collaboratory: https://resilienceandaging.com/

Collaboratory on Research Definitions for Reserve and Resilience in Cognitive Aging and Dementia: https://reserveandresilience.com

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Rajah, M.N., Dixon, R.A., Einstein, G. et al. A roadmap for conducting more inclusive research on brain resilience in ageing and dementia. Nat. Rev. Neurosci. (2026). https://doi.org/10.1038/s41583-025-01021-1

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