The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States

Author:

Simon Sharon Sanz123,Brucki Sonia Maria Dozzi4,Fonseca Luciana Mascarenhas35,Becker Jacqueline6,Cappi Carolina789,Marques Andrea Horvath10,Heyn Patricia C.11,Gonçalves Priscila Dib12,Martins Silvia S.12,Busatto Geraldo13,Bertola Laiss14,Suemoto Claudia Kimie15,Nitrini Ricardo3,Caramelli Paulo16,Yassuda Monica Sanches417,Miotto Eliane Correa3,Grinberg Lea Tenenholz18192021,Arce Renteria Miguel12,Alegria Margarita222324,Stern Yaakov12,Rivera‐Mindt Monica2526

Affiliation:

1. Cognitive Neuroscience Division Department of Neurology Columbia University Vagelos College of Physicians and Surgeons New York New York USA

2. Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology Columbia University Vagelos College of Physicians and Surgeons New York New York USA

3. Old Age Research Group, Department of Psychiatry University of São Paulo Medical School São Paulo São Paulo Brazil

4. Department of Neurology University of São Paulo Medical School São Paulo São Paulo Brazil

5. Department of Community and Behavioral Health Elson S. Floyd College of Medicine Washington State University Spokane Washington USA

6. Division of General Internal Medicine Icahn School of Medicine at Mount Sinai New York New York USA

7. Department of Psychiatry Icahn School of Medicine at Mount Sinai New York New York USA

8. Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York New York USA

9. Department of Psychiatry Clinics Hospital University of São Paulo School of Medicine São Paulo São Paulo Brazil

10. Elliott School International Affairs The George Washington University Washington District of Columbia USA

11. Center for Optimal Aging Department of Physical Therapy Marymount University Arlington Virginia USA

12. Department of Epidemiology Columbia University Mailman School of Public Health New York New York USA

13. Laboratory of Psychiatric Neuroimaging (LIM‐21) Department of Psychiatry University of São Paulo Medical School São Paulo São Paulo Brazil

14. Department of Psychiatry Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil

15. Division of Geriatrics Department of Clinical Medicine University of São Paulo Medical School São Paulo São Paulo Brazil

16. Behavioral and Cognitive Neurology Research Group Faculdade de Medicina Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil

17. Gerontology, School of Arts, Sciences, and Humanities University of São Paulo São Paulo São Paulo Brazil

18. Memory and Aging Center Department of Neurology University of California San Francisco San Francisco California USA

19. Department of Pathology University of California San Francisco San Francisco California USA

20. LIM‐22 Department of Pathology University of São Paulo Medical School São Paulo São Paulo Brazil

21. Global Brain Health Institute University of California San Francisco San Francisco California USA

22. Disparities Research Unit Department of Medicine Massachusetts General Hospital Boston Massachusetts USA

23. Department of Medicine Harvard Medical School Boston Massachusetts USA

24. Department of Psychiatry Harvard Medical School Boston Massachusetts USA

25. Department of Psychology Fordham University New York New York USA

26. Department of Neurology Icahn School of Medicine New York New York USA

Abstract

AbstractIntroductionThe Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group‐specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities.It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population.MethodsWe reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles.ResultsThis perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S‐residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials.ConclusionsThe recommendation and research efforts proposed should help to pave the way for the development of community‐engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally‐informed intervention to the U.S.‐residing Brazilian communities.HIGHLIGHTS The Brazilian population in the United States is growing but is underrepresented in U.S. health research. Approximately 71% of Brazilian immigrants in the United States are undocumented, with an increased risk for health inequities. Mental health is reported as a central health priority by Brazilian immigrants in the United States. There is a lack of research on Alzheimer's disease and other dementias (ADRD) in Brazilian immigrants in the United States. Epidemiological research is needed to map the prevalence/incidence of mental health conditions and ADRD risk factors among Brazilian immigrants in the United States.

Publisher

Wiley

Subject

Psychiatry and Mental health,Neurology (clinical)

Reference101 articles.

1. Brazilian_Foreign_Ministry.Comunidade Brasileira no Exterior – Estimativas Referentes ao ano de 2021.2021. Accessed May 4 2023. Retrieded from:https://www.gov.br/mre/pt‐br/assuntos/portal‐consular/arquivos/14‐09_brasileiros‐no‐exterior.pdf

2. Bureau U.S.C.Selected population profile in the United States.: 2021 American Community Survey 1‐year estimates.2021. Accessed May 2 2023.https://data.census.gov/table?q=brazilian

3. Understanding Health Priorities, Behaviors, and Service Utilization Among Brazilian Immigrant Women: Implications for Designing Community-Based Interventions

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