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

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.