Health Disparities and Dementia Care in Older Adults: A Narrative Review of Challenges and Solutions

Introduction: Rapid population aging among marginalized communities has heightened concerns over health disparities, particularly in relation to dementia among older adults. Socioeconomic challenges and limited healthcare access compound caregiving burdens and worsen health outcomes, further exacerbated by regional infrastructural disparities. This narrative review examines the intersection of dementia, caregiving challenges, and health inequities, with the goal of informing targeted interventions to enhance care quality. Methods: This narrative review was conducted following established guidelines for systematic reviews. Articles published between ۲۰۱۵ and ۲۰۲۵ were identified through scientific databases including PubMed, Web of Science, Scopus, and Embase. The inclusion criteria were based on the relevance of the article title to the main study topic and its publication within the specified period. Articles that did not meet these criteria or those with study designs unsuitable for inclusion, such as opinion pieces, case studies, and non-peer-reviewed articles, were excluded. A total of ۴۰ articles were initially found, of which ۱۸ met the inclusion criteria and were included in the study. Results: In the reviewed studies, ۴ articles reported a significant association between living in border regions and an increased prevalence of dementia among older Hispanic adults. This was particularly evident in regions with limited healthcare access and higher socioeconomic vulnerability. A notable finding was the substantial deterioration in activities of daily living (ADL) and instrumental activities of daily living (IADL) in border populations, with statistical significance (p < ۰.۰۱). Additionally, ۳ articles highlighted significant financial strain for older adults residing in border counties, especially in relation to healthcare costs. In terms of physical activity, ۲ studies indicated that individuals living in border areas engaged in significantly less physical activity, with a reduction of ۱۴.۳۶ minutes in walking time compared to those in non-border counties (p < ۰.۰۵). These findings collectively underscore the profound impact of geographic and socioeconomic factors on dementia care and health outcomes in border populations.