Skip to content
Frontiers
Search

Systematic Review

Frontiers in Dementia ·

Volume 5 - 2026 | https://doi.org/10.3389/frdem.2026.1779670

Mapping intersectionality in dementia care research: a decadal scoping review

  • Martina Roes1,2*corresponding author
  • Franziska Laporte Uribe1,2
  • Simone Anna Felding1,3
  • Georgina Charlesworth4
  • Nicole Müller5
  • Saloua Berdai6
  • Jem Bhatt4
  • Kuebra Altinok1,7
  • Viktoria Peters-Nehrenheim1,2
  1. 1German Center for Neurodegenerative Diseases (DZNE e.V.), Witten, Germany
  2. 2Faculty of Health, Department of Nursing Science, University of Witten/Herdecke, Witten, Germany
  3. 3Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  4. 4University College of London (UCL), London, United Kingdom
  5. 5University College Cork (UCC), Cork, Ireland
  6. 6Society and Ageing Research Lab, Vrije Universiteit Brussels, Brussels, Belgium
  7. 7Faculty for Health Care, University of Bielefeld, Bielefeld, Germany
Article metrics0 viewsView details
PDFCiteMetrics

Abstract

In the past decade, an increasing number of studies have addressed health care disparities and the complex determinants of care for diverse populations. At the same time, it remains unclear how social categories (e.g. gender, ethnicity, migration status, socioeconomic position) intersect with health care disparities for people living with dementia and may lead to experiences of inequity and inequality. This scoping review analyzes the use of intersectionality frameworks and intersection analyses in dementia care research over the past decade (2015–2025). We followed Arksey and O'Malley's six-stage scoping review methodology, extended with PRISMA guidelines and used the McCall framework to critically synthesize the included articles. We identified 14 articles that met our criteria for applying an intersectionality framework to analyze data. The most mentioned intersectionality frameworks in publications are from Crenshaw (n = 8), McCall (n = 7) as well as Hankivsky (n = 3) and Collins (n = 3). The target groups varied; mostly, the focus was on migrants, ethnicity, or sex/gender. Our results indicate a shift in dementia care research toward recognizing lived experiences shaped by multiple axes of identity and contexts. At the same time the primary analytical focus lies in the intersection of two axes of identity (such as sex/gender and ethnicity/migration). A detailed analysis of power dynamics within the healthcare system or the society, and how they may contribute to the experiences of the target group, was mostly not conducted or only mentioned that there is a need to do so.

Keywords

Introduction

Intersectionality, a concept first developed by Crenshaw (1989) highlights, how different systems of power intersect and interact with axes of identity and therefore lead to specific disadvantages (e.g., low income) or advantages (e.g., wealthy people) for population groups or individuals. She criticizes approaches that analyze social problems through only one lens (such as ethnicity), arguing that the complexity of real life needs to be considered in order to understand people's experiences. For example, the experiences of Black women cannot be understood by only applying the concept of racism. Rather, analyses need to consider how experiences are shaped by the conjunction of ethnicity and other social constructs and their respective layers of discrimination (Carbado et al., 2013). Crenshaw's framework emphasizes that the intersecting dynamics of the axes of identity and societal norms, laws and/or policies must be analyzed together to be able to identify and understand experiences of inequality and inequity.

Crenshaw (1989) characterized intersectionality as an analytical tool and a mindset about power within our societies, illustrated by the positioning of Black women (Crenshaw, 1991) and distinguishes between structural and political intersectionality. Following the publication of her work, the concept of intersectionality has been theorized in different ways: McCall (2005) focuses on a conceptional approach and introduces anti-, inter-, and intra-categorial approaches to study inequalities. Her framework can be used to analyze intersectional power dynamics. Hankivsky (2014) adopts an equity-policy perspective and notes that power relations and operational structures can be analyzed across micro-, meso and macro levels. Her framework, Intersectionality-Based Policy Analysis (IBPA), can be applied to analyze research, policy, and practice. Collins (2019) defines intersectionality as a critical social theory with core constructs (e.g., relationality, complexity). Her framework provides a formalized theoretical architecture of intersectionality across contexts (Collins et al., 2021). Hancock (2016) views an intersectionality framework as a research paradigm, with a specific focus on political science and policy research. She points out that it is necessary to move from what intersectionality is toward how intersectionality can reconfigure research (Hancock, 2007). Bowleg (2012) links intersectionality to public health and highlights how interlocking systems of power and oppression shape the lived experience of individuals. Her focus lies in institutional critique and the need for policy-level-analysis (Bowleg, 2017). These intersectional frameworks emphasize systems of power that intersect with constitutive categories and reject decontextualized models of inequality and inequity.

The experiences of people living with dementia (PLWD) are heterogeneous and differ at the intersection of the axes of identity (e.g., age, ethnicity), social geography (e.g., where one lives) and societal context (e.g., income). Analyzing complex individual experiences through the lens of intersectionality enables researchers to uncover inequalities/inequities and their dynamics that would otherwise remain invisible within the health care system. Therefore, it is important to understand dementia not only from the perspective of a neurodegenerative disease, but as a social construct, arguing that dementia is a label that shapes how people living with dementia are treated by society. Experiences, such as stigma, taking away autonomy and citizen rights, ignoring personhood and decision-making capacity, suggest that dementia is also socially constructed (Parker et al., 2021). Applying an intersectional lens in dementia care research can support improvements to health care systems to make them more responsive to populations with overlapping vulnerabilities, to move beyond simplistic group comparisons, and instead to ask how power, marginalization, and privilege are produced in everyday care and how the resulting disadvantage can be addressed structurally.

Intersectionality began to explicitly enter dementia care research around the early 2010s, although references to preliminary ideas of “multiple disadvantage” or “cultural diversity” appeared earlier. However, systematic engagement with intersectionality frameworks did not become prominent in the literature until the mid-2010s (Hengelaar et al., 2023). Early dementia care studies applying an intersectional lens addressed topics such as gender and citizenship (Bartlett et al., 2018), ethnicity or migration status (Dilworth-Anderson and Anderson, 1994) and/or language skills (Koehn et al., 2016), which impact access to the healthcare system or to a timely diagnosis. These early studies analyzed differences in care experiences within different health care systems (Hulko, 2004), but mostly considered aspects of identity in an additive manner (Hicks et al., 2025; O'Connor et al., 2010).

The growing use of intersectionality as an analytical framework in dementia care research aims to identify and address gaps in perspectives, exclusion, and discrimination faced by marginalized groups. Therefore, the aim of our scoping review is to provide an overview of the use of intersectionality frameworks in dementia care research over the past decade (2015–2025).

Methods

Our review follows (Arksey and O'malley, 2005) six-stage scoping review methodology, extended with the PRISMA guidelines. Stage 1: identifying the research question; Stage 2: identifying relevant studies; Stage 3: selecting studies; Stage 4: charting the data; Stage 5: collating, summarizing, and reporting the results; and Stage 6: consulting with experts.

Stage 1 research question

Our guiding research question was the following: which intersectionality frameworks have been applied in dementia care research published between 2015 and 2025?

Stage 2 search strategy

Searches for relevant articles were conducted in six different databases (PubMed, PsychInfo, Scopus, CINAHL, Embase and Web of Science). The search string was adjusted for the different data bases (see Supplement 1) with overarching terms being: (“dementia” OR “Alzheimer*”) AND (“intersectionality” OR “intersectional” OR “multidimensional identity” OR “structural inequality” OR “disparities” OR “migrants” OR “minority group” OR “social determinants”) AND (“care” OR “caregivers” OR “healthcare” OR “support” OR “service”) AND (“framework” OR “analysis” OR “approach” OR “model”). Articles were retrieved, and duplicates were deleted. The articles were downloaded into an EndNote file.

Stage 3 study selection

We followed the Population, Concept, and Context (PCC) framework (Peters et al., 2022) (Table 1) in which the population included people living with dementia or family/informal carers of people living with dementia or health professionals taking care of people living with dementia. Articles must contain reference to an intersectional framework (concept), applied to a dementia care setting (context). Papers were eligible if they were original papers or reviews (peer reviewed) with a clear link to dementia care (research), published between 2015–2025 in either English or German. Gray literature, conceptual papers, editorials, abstracts or posters and dissertations were excluded, as were biomedical articles.

Table 1. PCC criteria.

PCCInclusionExclusion
PopulationPeople with dementia or family/informal carers of people with dementia or health professionals taking care of people with dementiaArticles/studies that do not focus on people with dementia
ConceptThe phenomenon of interest is the application of an intersectional framework in dementia care researchArticles/studies not including an intersectional framework in dementia care research
ContextDementia care research contextsNo dementia care research setting

PCC criteria

Since the number of articles identified for title/abstract (TiAb) screening was relatively low, we used only the EndNote file and reviewed the identified articles independently (MR and FLU). In case of conflict a third researcher (VPN) was included to reach consensus. Reference lists of excluded reviews were searched, with potentially eligible studies screened.

Stage 4 data charting

MR extracted data from all the articles and discussed articles with the co-authors. Data extraction focused on authors, year, title, applied intersectionality framework, research question, target group, key outcomes, and author conclusions.

Stage 5 collating and summarizing

All included articles were analyzed by searching for any mention and application of an intersectionality framework. These questions were used to guide the analysis:

  • Aim/research question: does the aim or research question mention an intersectionality framework?
  • Sample size: is the target group clearly described? Which characteristics are described?
  • Methods: which methods were used to operationalize the chosen intersectionality framework?
  • Axes of identity: which identity markers were been considered/analyzed? Which contextual details are been provided?
  • Power dynamics: are power relations mentioned/described between axes of identity and the social system / the health care system? Are experiences of inequity or inequality mentioned / described?

Stage 6

Consultation was conducted with the members of the INTERDEM taskforce “Context, Culture, and Intersectionality” during our scheduled meetings. INTERDEM is a European Dementia Care Research Network (https://interdem.org), founded in 1999. The network consists of different taskforces. The authors of this scoping review are all members of the taskforce “Context, Culture, and Intersectionality,” which was initiated in 2019 (https://interdem.org/?page_id=7329).

Results

The results are presented in three parts: (1) study identification, including a PRISMA flowchart (Figure 1); (2) the data extraction table showing the study characteristics of included articles; and (3) a critical reflection on the respectively applied intersectionality frameworks.

PRISMA flowchart.
Figure 1. PRISMA flowchart.

PRISMA flowchart

Study identification

In total 870 articles were retrieved. Among these, 320 were duplicates, 550 articles were subjected to Ti/Ab screening by MR, and the first 10 articles were discussed with a 2nd researcher (FLU or VPN). 110 articles were eligible for full text screening. Thirteen articles were included in this review (Table 2 and 3).

Table 2. Study characteristics (incl. intersectionality framework) (alphabetical order).

AuthorsTitle of the articleIntersectionality FrameworkResearch Design & methodsPopulationKey Findings
Ahmad et al. (2022)Dementia care-sharing and migration: An intersectional analysis of family care practicesCrenshaw (1989, 1991) [original intersectionality concept] and Prins (2006) [a systemic approach foregrounding structure and a constructionist approach foregrounding agency] and Phoenix (2011, 2006) [that researchers should inductively decide which intersections matter in context]Qualitative: Life-story interviews and shadowingMigrant family carers providing care to relatives with dementia•Highlights unequal care burdens for migrant women and how structural conditions (labor markets, welfare rules) shape intra-familiar negotiations •how gender, migration trajectories, class and legal status interact to distribute and constrain care roles
Altinok et al. (2025)Intersectional research on dementia care for post-migrants and ethnic minority groups: a scoping reviewCrenshaw (1989, 1991) [original intersectionality concept]Scoping reviewPost-migrants & ethnic minorities people with dementia and carers•Preferences are not linked to intersectional determinants •Personal preferences are shaped by intersecting cultural values, language barriers, immigration processes, shifting socioeconomic positions and gender roles •Underscores system-level neglect of these intersections in service planning.
Ghanem et al. (2025)Key considerations for applying intersectionality theory to partner and stakeholder engagement in public healthHankivsky (2012) [Intersectionality-Based Policy Analysis (IBPA) Framework] to provide a method on how to analyse health policy (reports)Literature reviewDifferent stakeholders•Calls for incorporating intersectionality principles in partner-stakeholder engagement (PSE) in public health •Encouraging critical reflection on the who, why, and how of PSE
Mwale et al. (2025)Privileges, and permissions: theorising intersectionality and cultures of control in the care of people living with dementia in acute hospital settingsPhoenix (2006) concept of intersectionality and relational powerEthnographic observationsDementia patients in acute hospitals in UK•Institutional power systems drive inequalities and intersectionality exposes structures •Critique and deconstruct frameworks of exclusion and control embedded in hospital cultures
Liu et al. (2022)Caregiving Burden Among Caregivers Through Lens of IntersectionalityCrenshaw (1989) [original intersectionality concept] and Hankivsky (2012) [health equity intersectionality framework] an McCall (2005) [methodology]Quantitative: Logistic regressionInformal caregivers•Ethnicity/gender intersections yield distinct burdens •Tailored interventions are needed
Roes et al. (2022)Intersectionality and its relevance for research in dementia care of people with a migration backgroundBowleg (2012), Collins (2019) [intersectionality concept]; Crenshaw (1989) [original intersectionality concept]; Hankivsky (2012) [Intersectionality-Based Policy] Analysis (IBPA); McCall (2005) three different categorical approachesPerspective PaperPeople with dementia and migration history•Interlocking identities reveal systemic care barriers •Advancing intersectionality is needed to understand exclusion from dementia care
Sherman et al. (2023)Intersectionality in nursing research: A scoping reviewProvides a brief overview of different intersectionality frameworks (e.g. Crenshaw, Bowleg), not dementia research specificScoping reviewNursing/dementia care recipients•More explicit use of intersectionality frameworks needed
Wong et al. (2024)Living with dementia: Exploring the intersections of culture, race, and dementia, stigmaCrenshaw (1989) [original intersectionality concept] and Collins (2019) [intersectionality as a critical social theory] and Applying McCall's (2005) intra-categorical approachQualitative: interviewsImmigrant PWLD and caregivers living in Canada•Identifies how racism, cultural norms, immigration histories and cognitive impairment interact •Producing layered stigma, social exclusion, and barriers to support •Highlights power in health encounters and service access.

Bold values highlighting the authors.

Table 3. Study characteristics, no specific intersectionality framework (alphabetical order).

AuthorsTitle of the articleFocus on intersections, not explicit an intersectional frameworkResearch Design & methodsPopulationKey Findings
Bartlett (2022)Inclusive (social) citizenship and persons with dementiaSingle-axis2 gender lens to argue for includes social citizenshipQualitative: Go-along walking followed by sitdown interviewsPeople with dementia and caregivers in EnglandIdentity and agency reconstructed across intersecting axes • Agency depends on intersectional •recognition
Bartlett et al. (2018)Gender, citizenship and dementia care: a scoping review of studies to inform policy and future researchSingle-axis gender lens (e.g. Lister (2003); Lehter by 2003) to expose gendered norms, policy discourses and care practicesScoping reviewFamily carers of people with dementia• Need to address gender, migration, policy together •• Intersectionality essential for inclusion
Misiura et al. (2023)Intersectionality in Alzheimer's Disease: the role of female sex and Black American race in the development and prevalence of ADintersecting axes of sex and race, such as female biological sex, Black American race/ethno-racial identity, and a set of social determinants of health (poverty, education, discrimination, allostatic load, vascular risk factors, access to care, under-representation in trials)Selective literature reviewBlack female Americans with Alzheimer's Disease• Social and biological factors, such as allostatic load and hormone use, intersect to increase Alzheimer's •Disease risk
Shippee et al. (2024)Scoping literature review: experiences of sexual and gender minority older adults with diagnoses of dementia, who use residential longterm services and supportsfocus on how individual, interpersonal, organizational, community and policy-level factors interact to shape health outcomes (e.g. McLeroy et al., 1988)Scoping reviewSexual & gender minority older adults with dementia• Sexual, gender, minority (SGM) older adults encounter compounded discrimination • Risk is magnified (e.g., transgender, racial minorities, HIV+) • Facility and staff often remain •inadequate
Zacher et al. (2023)Geographic Patterns of Dementia in the United States: Variation by Place of Residence, Place of Birth, and SubpopulationIntersection of place and subpopulation using a life course and social special health disparity lens (e.g. Akushevich et al., 2021)Quantitative: Logistic regressionPeople with dementia living in the US• Disadvantage and nuanced patterns of dementia prevalence embedded within •place and subpopulation groupings

Bold values highlighting the intersectional aspect.

Study characteristics (alphabetical order)

The applied intersectionality frameworks

In the 13 articles included in this scoping review, several intersectionality frameworks were applied. To obtain a better understanding of the frameworks, brief explanations are provided below: axes of identity and social positions, analysis of power dynamics and understanding of inequity and inequality. To identify axes of identity and social positions, we defined relevant social categories (axes) and linked these with provided details of social positioning. To identify details which would provide an understanding of power dynamics we conducted a deductive thematic analysis using key aspects from the applied intersectional framework. To understand which aspects can be linked to inequity and inequality we searched primarily for details addressing the lived experiences of the person with dementia and/or their caregivers.

Axes of identity and social positions

Several axes of identity and social positioning were analyzed across the 13 included articles.

  • Migration status/ethnicity/race: these categories are understood as central to understanding stigma, barriers to access to care or the health care system and/or values of care (Ahmad et al., 2022; Altinok et al., 2025; Wong et al., 2024).
  • Socioeconomic position: this social position is mostly linked to immigration status, professional job and/or welfare system access and use, and analyzing how these intersections shape health care, e.g., what kind of care services are affordable and/or accessible (Ahmad et al., 2022; Liu et al., 2022; Roes et al., 2022).
  • Place and legal status: geographic location (e.g., urban vs. rural, country of residence) and legal status impact, for example eligibility, proximity to appropriate services and exposure to discrimination (Ahmad et al., 2022; Roes et al., 2022; Zacher et al., 2023).
  • Language and culture: these are intersecting identity markers linked to communication with the health care system as well as perceptions and concepts of dementia (Altinok et al., 2025; Wong et al., 2024).
  • Sex and gender: these are analyzed at the intersection of kin role within the care requirements and dynamics in care situations and highlight gendered expectations and burden (Liu et al., 2022; Misiura et al., 2023; Shippee et al., 2024). Sexual and gender minority groups with dementia experience discrimination at three different levels (individual, interpersonal, institutional) when living in a nursing home or in a heteronormative (exclusively) long-term care facility in which staff have various knowledge gaps (Shippee et al., 2024).

Analysis of power dynamics

The application of the intersectionality frameworks with a specific focus on power dynamics was not addressed directly in any of the 13 included articles.

  • Ahmad et al. (2022) analyzed the effects of transnational migration processes, gender norms, and labor structures on who provides care and who receives care, applying Hankvisky's framework. They showed that migrant women are more often working as unpaid carers while navigating precarious employment and restrictive welfare services. The authors conclude that these results illustrate structural and institutional power within the healthcare system.
  • Mwale et al. (2025) focus lies on institutional power at the intersection of age, race/ethnicity, socioeconomic status and dementia in acute hospitals. Applying the framework developed by Collins, they analyzed how these intersections impact hospital experience (e.g., if and how care needs are recognized). The authors conclude that privilege and marginalization are the product of the power dynamics between identity axes and institutional regulations and norms.
  • Roes et al. (2022) describe how different intersectionality frameworks (Crenshaw, McCall, Hanskivsky) can be used to uncover discrimination, ignorance and exclusion of population groups (e.g., PLWD with a migration background) in dementia regulations or treatment and care strategies. The authors conclude that an intersectional analysis must extend beyond describing intersections toward interrogating structural power and policy-level neglect.
  • Wong et al. (2024) apply an intra-categorial approach (McCall) to analyze how race (ethnicity), culture and immigration status interact with dementia and experiences of stigma, discrimination and social exclusion. The analysis revealed that power relations are visible in narratives of different treatments by healthcare professionals. The authors conclude that the individual experiences can be explained based on immigration-related power structures.

Understanding inequity and inequality

In some of the included articles we were able to see reasoning regarding experiences of inequity and inequality. Inequality refers to an unequal distribution of resources (e.g., differences in wealth), whereas inequity refers to unfairness and injustice (e.g., access to dementia services). Inequity is the result of human behavior, social structures and/or policies, and therefore can be avoided.

In the included articles four topics were addressed:

  • PLWD experience different levels of access to diagnosis and dementia care services on the basis of a combination of intersections of migration status/ethnicity, language barriers, cultural expectations, and a low socioeconomic level. The interlockings of these intersections can be used to explain delayed diagnostic processes and challenges navigating the health care system as well as accessing/utilizing formal services (Ahmad et al., 2022; Altinok et al., 2025; Roes et al., 2022; Wong et al., 2024).
  • Experiences of care burden intersect with sex/gender and migration status which is also interlocked with the unequal distribution of unpaid work and is constraint by (difficult) economic conditions, which reinforces inequalities (Ahmad et al., 2022).
  • PLWD experience double discrimination due to the diagnosis and race/ethnicity/migration history. These experiences lead to social isolation and the misrecognition of dementia care needs. An analysis of these experiences through a lens of power dynamics and oppression shows that they are not just individual prejudices but structural manifestations of marginalization (Wong et al., 2024).
  • PLWD experience institutional ignorance at the intersection of dementia diagnosis, age, ethnicity/race/migration status and socioeconomic status. In acute hospitals, they face mostly ignorant behaviors related to their needs, preferences, and voice. This can be understood as reproducing institutionalized inequities for PLWD who need acute care (Mwale et al., 2025).

Discussion

With our scoping review, we show that although intersectionality frameworks have been applied in dementia care studies, theoretically grounded intersectional work remains sparse. Our analysis revealed a few research gaps: (a) underrepresentation of minority groups in dementia care research; (b) primarily focus lies on intersections, not on the analysis of underlying power dynamics; (c) unclear methodology how respective frameworks are applied; (d) theoretical background applied to analyze a phenomenon was in most cases not defined.

One of the greatest gaps lies in the underrepresentation of minority groups/ marginalized identities (Adames et al., 2020; Hafford-Letchfield, 2024; Wong et al., 2024) in research, resulting in a lack of tailored data. Another gap is that only a few studies have operationalized intersectionality with robust definitions and/or measures. Going back to the original framework of intersectionality (Crenshaw, 1989) and based on the included articles in this scoping review, it still seems necessary, to address the coloniality of power (Quijano, 2000) and its ongoing impact on knowledge production and language e.g., racial social classification of the world population, (Restrepo, 2018). For example, from the perspective of dementia research conducted in Europe we need to critically reflect on Eurocentric diagnostic norms (Nielsen, 2022), care models (Ahmad and The, 2025), research priorities and dementia strategies (Schmachtenberg et al., 2020). Due to the underrepresentation and missing critical reflection of production of knowledge and power, psychosocial interventions will not be tailored to the needs of care recipients with intersecting marginalized identities, and assessments lack validation for diverse populations.

Most studies mention the intersection of multiple axes of identity, but consider race/ethnicity/migration, sex/gender, age, or socioeconomic status more as separate covariates or descriptive subgroups. None of the studies have conducted intersectional power analyses or used one of the most cited intersectionality frameworks to directly analyze power dynamics to understand reasons for experiences of inequity and/or inequality. For example, power dynamics that operate through institutional cultures of control (Voruz, 2005) and/or everyday rules. Analyzing power dynamics requires more than simply documenting unequal outcomes. Thus, the gap lies between deciding to use an intersectionality framework and its operationalization as a critical analysis of the interlocking systems and axes of identity in dementia care research designs, analysis, and interpretations.

From a conceptual perspective, almost all included articles considered a combination of at least two intersectionality frameworks. Unfortunately, methodological details on how the frameworks were applied, were missing. From our perspective, the provision of methodological details on how to apply the intersectionality framework (e.g., IBPA, McCall's categorial system, or Bowleg's health equity guidance) would support strong performances and helps identify asymmetries within the various health care systems; for example combining intra-categorical qualitative approaches (for deep analysis of marginalized intersections) with inter-categorical perspectives (to compare patterns across intersections), and explicitly locating micro-experiences within structural determinants. An exception is the study from Mwale et al. (2025) on theorizing intersectionality and cultures of control of people living with dementia in acute hospital settings.

Moreover, dementia care research needs to be expanded by using relevant conceptual models and theoretical perspectives, for example, gender theory and/or critical feminist-post-humanist approaches (Finn and Brown, 2022). Since most family caregivers are women, it is no surprise that intersectionality and feminist / gender theories are emerging in dementia studies. For example, Bartlett (2022) criticizes that sex/gender neutrality (e.g., not including the sex of the caregiver) appears as a negative way of diminishing sex/gender in dementia care studies. She points out, that gender neutral language (people with dementia) can be viewed as a way of excluding this aspect of the identity in dementia care setting. However, a gender-neutral language could be beneficial for people who do not agree with existing sex and gender norms (Lotherington, 2023). For example, sexual and gender minoritized (SGM) people living with dementia have explicitly addressed ways in which multiple forms of oppression (e.g., ethnocentrism, cis-sexism, heterosexism) uniquely impact their experiences of inequity and/or inequality (Adames et al., 2020; Europe, 2021; Stites and Velocci, 2024).

Furthermore, there is a need to advance dementia care research. Moving away from treating demographic variables as independent confounders toward understanding the intersections, the structural systems of power, which lead to inequities and inequalities. We recommend three key actions.

  • Methodological and analytical advancements: there is a need to move beyond simple comparison (e.g., white vs. minority groups) and on to analyze the combined impact of the overlapping intersections (e.g., living in a rural and poor neighborhood with a biography of being a migrant) on patient related outcomes (Tobin Thomas et al., 2023). Conducting multilevel analyses of individual heterogeneity and discriminatory accuracy (MAHIDA) is a quantitative, intersectional approach to analyze socio-demographic inequalities (Wilkes and Karimi, 2024). Applying mixed-method approaches to analyze the how and why of intersecting experiences and striving for global equity data science (Vilor-Tejedor et al., 2026) is needed too.
  • Integrating health disparities and structural factors: there is a need to analyze how structural determinants impact disparities in dementia incidence/prevalence, diagnosis, treatment and care (Balls-Berry and Babulal, 2022). The analysis of double jeopardy of individual holding multiple marginalized identities (e.g., people with intellectual and developmental disabilities) will help to explain patient reported outcomes (Marks et al., 2025).
  • Reconsider research designs: there is a need to reconsider recruitment strategies specifically from populations facing high level of inequity (e.g., LGBTQI+, ethnic minority groups, indigenous communities) to ensure adequate sample size for intersectional analysis (Maestre et al., 2024). The implementation of community-based-participatory research seems to be an effective way to ensure that research topics are relevant to marginalized communities (Collins et al., 2018), which also has an impact on implementing innovative interventions (Fischer et al., 2025). Additionally, developing longitudinal datasets might lead to a better understanding of structural determinants (e.g., neighborhood deprivation) and its impact on patient reported outcomes (Vilor-Tejedor et al., 2026).

Conclusion

Our scoping review is to our knowledge the first attempt to critically analyze the application of intersectionality frameworks in dementia care research. The development of intersectional frameworks began with the aim of conceptually advocating for population groups (such as Black women) that are underrepresented (ignored or defined as hard to reach) and has progressed to offering a variation of different frameworks as well as methods and research applications. There are some indications, that intersectionality frameworks are now used as both theoretical and analytical strategies by specifying axes of identity and the location of power dynamics within systems of power, and furthermore in analyzing the narrative experiences, to better understand inequity and inequality.

Among the included articles, most focused on analyzing the intersection of axes of identity, but these analytical results were not viewed through the lens of power dynamics and oppression in all cases. Based on the similarities of all intersectionality frameworks, solely analyzing the intersection of identity axes is insufficient to understand experiences of inequity and inequality. An intersectional power analysis would need the following: (a) an explicitly defined system (e.g., sexism, migration regulations) that interlocks with observed outcomes of oppression; (b) a connection between individual experiences (e.g., stigma, exclusion) and different levels of organizational/institutional norms (e.g., admission practices to acute hospitals or access to care services) and policies (e.g., national dementia plans or professional guidelines); and (c) an understanding of the axes of identity and power dynamics within a society (or the health care system) as historically situated and relational (i.e., interlocking).

We believe that the recent increase in the adoption of intersectional approaches will enable dementia care research that analyzes not only different categories or social axes of identity but also the dynamics and relations between these categories embedded in their specific context and how they are produced by their conjunction (Dilworth-Anderson et al., 2020).

Limitations

We primarily focused on studies and articles from the (dementia) health care research spectrum. We therefore may have missed other intersectionality frameworks applied in other disciplines, such as anthropology. For example, sociocultural anthropologists value origin stories and understand them as windows into social worlds as well as treasure origin stories to recognize the history of a story (Miller, 2025; Thimm, 2025).

Generative AI statement

The author(s) declared that Generative AI was not used in the creation of this manuscript.

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/frdem.2026.1779670/full#supplementary-material

Supplementary material Supplementary material at the source

Supplementary material Supplementary material at the source

Supplementary material Supplementary material at the source

Footnotes

Edited by: Sibille Merz, Alice Salomon University, Germany

Reviewed by: Ladson Hinton, UC Davis Health, United States

Meghánn Catherine Ward, Bilkent University, Türkiye

Statements

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The author MR declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Funding

The author(s) declared that financial support was not received for this work and/or its publication.

Author contributions

MR: Conceptualization, Data curation, Formal analysis, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. FL: Conceptualization, Methodology, Validation, Writing – review & editing. SF: Writing – review & editing. GC: Writing – review & editing. NM: Conceptualization, Writing – review & editing. SB: Conceptualization, Methodology, Writing – review & editing. JB: Conceptualization, Methodology, Writing – review & editing. KA: Writing – review & editing. VP-N: Writing – review & editing.

Acknowledgements

We acknowledge the highly relevant contributions (commenting the final manuscript) of the members of the INTERDEM taskforce “Context, Culture, and intersectionality.” Furthermore, the authors thank our student (Lizzy Kersten) for keeping track of the references.

References

  1. Adames H. Y., Chavez-Dueñas N. Y., Salas S. P., Manley C. R. (2020). “Intersectionality as a practice of dementia care for sexual and gender minoritized latinxs,” in Caring for Latinxs with Dementia in a Globalized World: Behavioral and Psychosocial Treatments, eds. Adames H. Y., Tazeau Y. N. (New York, NY: Springer New York), 205 – 229. doi: doi:10.1007/978-1-0716-0132-7_12
  2. Ahmad M. The A.-M. (2025). Beyond ‘culturally sensitive care': reimagining dementia care for families with migration backgrounds. Soc. Sci. 14: 404. doi: doi:10.3390/socsci14070404
  3. Ahmad M., van den Broeke J., Aharso S., Tonkens E. (2022). Dementia care-sharing and migration: an intersectional exploration of family carers' experiences. J. Aging Stud. 60: 100996. doi: doi:10.1016/j.jaging.2021.100996
  4. Altinok K., Güney S., Yüceer B., Razum O., Roes M. (2025). Intersectional research on dementia care for post-migrants and ethnic minority groups: a scoping review. Front. Dement 4: 1596395. doi: doi:10.3389/frdem.2025.1596395
  5. Arksey H., O'malley L. (2005) Scoping studies: towards a methodological framework. Int. J. Soc. Res. Methodol. 8, 19 – 32. doi: doi:10.1080/1364557032000119616
  6. Balls-Berry J. J. E., Babulal G. M. (2022). Health disparities in dementia. Continuum (Minneap Minn). 28, 872 – 884. doi: doi:10.1212/CON.0000000000001088
  7. Bartlett R. (2022). Inclusive (social) citizenship and persons with dementia. Disability Soc., 37, 1129 – 1145. doi: doi:10.1080/09687599.2021.1877115
  8. Bartlett R., Gjernes T., Lotherington A-. T., Obstefelder A. (2018). Gender, citizenship and dementia care: a scoping review of studies to inform policy and future research. Health Soc. Care Commun. 26, 14 – 26. doi: doi:10.1111/hsc.12340
  9. Bowleg L. (2012). The problem with the phrase women and minorities: intersectionality—an important theoretical framework for public health. Am. J. Public Health 102, 1267 – 1273. doi: doi:10.2105/AJPH.2012.300750
  10. Bowleg L. (2017). “Intersectionality: an underutilized but essential theoretical framework for social psychology,” in The Palgrave Handbook of Critical Social Psychology, ed. Gough B. (London: Palgrave Macmillan UK), 507 – 529. doi: doi:10.1057/978-1-137-51018-1_25
  11. Carbado D. W., Crenshaw K. W., Mays V. M., Tomlinson B. (2013). Intersectionality: mapping the movements of a theory 1. Du Bois Rev. Soc. Sci. Res. Race 10, 303 – 312. doi: doi:10.1017/S1742058X13000349
  12. Collins P. H. (2019). Intersectionality as Critical Social Theory. Durham, NC: Duke University Press. doi: doi:10.1215/9781478007098
  13. Collins P. H., Bilge S. (2020). Intersectionality. Cambridge: Polity press.
  14. Collins P. H., da Silva C. G., Ergun E., Furseth E., Bond I. K. D., Martínez-Palacios J. (2021) Intersectionality as critical social theory. Contemp. Political Theory 20, 690 – 725. doi: doi:10.1057/s41296-021-00490-0
  15. Collins S. E., Clifasefi S. L., Stanton J., The Leap Advisory Board Straits K. J. E., Gil-Kashiwabara E.. (2018). Community-based participatory research (CBPR): towards equitable involvement of community in psychology research. Am. Psychol. 73, 884 – 898. doi: doi:10.1037/amp0000167
  16. Crenshaw K. (1989). Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum.
  17. Crenshaw K. (1991). Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanford Law Rev. 43, 1241 – 1299. doi: doi:10.2307/1229039
  18. Dilworth-Anderson P., Anderson N. B. (1994). “Dementia caregiving in blacks: a contextual approach to research,” Stress Effects on Family Caregivers of Alzheimer's Patients: Research and Interventions, eds. Light E., Niederehe G., Lebowitz B. D. (New York, NY: Springer Publishing Company), 385 – 409.
  19. Dilworth-Anderson P., Moon H., Aranda M. P. (2020). Dementia caregiving research: expanding and reframing the lens of diversity, inclusivity, and intersectionality. Gerontologist 60, 797 – 805. doi: doi:10.1093/geront/gnaa050
  20. Europe A. (2021). Sex, gender and sexuality in the context of dementia (Discussion Paper). Alzheimer Europe.
  21. Finn G. M., Brown M. E. L. (2022). Ova-looking feminist theory: a call for consideration within health professions education and research. Adv. Health Sci. Educ. 27, 893 – 913. doi: doi:10.1007/s10459-022-10108-8
  22. Fischer H., Hanefeld J., Koduah A. (2025). Implementation science and power: equity-oriented implementation science needs a power lens. Lancet Global Health 14, e179 – e180. doi: doi:10.1016/S2214-109X(25)00395-X
  23. Ghanem S., Marulappa N., Qiang V. (2025). Key considerations for applying intersectionality theory to partner and stakeholder engagement in public health. Can J Public Health. 116, 896 – 905. doi: doi:10.17269/s41997-025-01023-7
  24. Hafford-Letchfield T. (2024). Intersecting sex and gender diversity with sexual rights for people living with dementia in later life: an example of developing a learning framework for policy and practice. Front. Dementia 3: 1349023. doi: doi:10.3389/frdem.2024.1349023
  25. Hancock A.-M. (2007). When multiplication doesn't equal quick addition: examining intersectionality as a research paradigm. Perspect Politics 5, 63 – 79. doi: doi:10.1017/S1537592707070065
  26. Hancock A. M. (2016). Intersectionality: An Intellectual History. Oxford: Oxford University Press. doi: doi:10.1093/acprof:oso/9780199370368.001.0001
  27. Hankivsky O. (2012). An Intersectionality-Based Policy Analysis Framework. (Accessed January 2025).
  28. Hankivsky O. (2014). Intersectionality 101 The Institute for Intersectionality Research and Policy. Burnaby, BC: SFU.
  29. Hengelaar A. H., Wittenberg Y., Kwekkeboom R., Van Hartingsveldt M., Verdonk P. (2023). Intersectionality in informal care research: a scoping review. Scandinavian J. Public Health 51, 106 – 124. doi: doi:10.1177/14034948211027816
  30. Hicks B., Wheatley K., Porter E., Farina N., Banerjee S. (2025). A mapping review of studies exploring the barriers and facilitators to a dementia diagnosis through an intersectionality lens. BJPsych Open 11: e76. doi: doi:10.1192/bjo.2025.17
  31. Hulko W. (2004). Dementia and intersectionality: exploring the experiences of older people with dementia and their significant others. Available online at: (Accessed January, 2025).
  32. Koehn S., Badger M., Cohen C., McCleary L., Drummond N. (2016). Negotiating access to a diagnosis of dementia: implications for policies in health and social care. Dementia 15, 1436 – 1456. doi: doi:10.1177/1471301214563551
  33. Lister R. (2003) Citizenship: Feminist Perspectives. Palgrave Macmillan
  34. Liu R., Chi I., Wu S. (2022). Caregiving burden among caregivers of people with dementia through the lens of intersectionality. Gerontologist 62, 650 – 661. doi: doi:10.1093/geront/gnab146
  35. Lotherington A. T. (2023). Gender Awareness and Feminist Approaches in Dementia Studies: A Critical History of Dementia Studies. (Abingdon: Routledge), 83 – 94. doi: doi:10.4324/9781003290353-10
  36. Maestre G., Hill C., Griffin P., Hall S., Hu W., Flatt J.. (2024). Promoting diverse perspectives: addressing health disparities related to Alzheimer's and all dementias. Alzheimer's Dement. 20, 3099 – 3107. doi: doi:10.1002/alz.13752
  37. Marks B., Sisirak J., Janicki M. P., Service K. P., Watchman K. (2025). Advancing inclusive brain health and dementia care for people with intellectual and developmental disabilities: a public health framework. Gerontologist 65 (Supplement_1), S60 – S67. doi: doi:10.1093/geront/gnaf222
  38. McCall L. (2005). The complexity of intersectionality. Signs. 30, 1771 – 1800. doi: doi:10.1086/426800
  39. McLeroy K. R., Bibeau D., Steckler A., Glanz K. (1988). An ecological perspective on health promotion programs. Health Educ. Q. 15, 351 – 377. doi: doi:10.1177/109019818801500401
  40. Miller B. (2025). Intersectionality theory in sociocultural anthropology. Humans 5: 11. doi: doi:10.3390/humans5020011
  41. Misiura M. B., Butts B., Hammerschlag B., Munkombwe C., Bird A., Fyffe M.. (2023). Intersectionality in alzheimer's disease: the role of female sex and black american race in the development and prevalence of alzheimer's disease. Neurotherapeutics, 20, 1019 – 1036. doi: doi:10.1007/s13311-023-01408-x
  42. Mwale S., Northcott A., Featherstone K. (2025). Privileges, and permissions: theorising intersectionality and cultures of control in the care of people living with dementia in acute hospital settings. Sociol. Health Illn. 47: e13869. doi: doi:10.1111/1467-9566.13869
  43. Nielsen T. R. (2022). Cognitive assessment in culturally, linguistically, and educationally diverse older populations in Europe. Am J Alzheimer's Dis Other Dementias 37: 15333175221117006. doi: doi:10.1177/15333175221117006
  44. O'Connor D., Phinney a, Hulko W (2010) Dementia at the intersections: a unique case study exploring social location. J Aging Stud. 24, 30 – 39. doi:. doi:10.1016/j.jaging.2008.08.001
  45. Parker J., Cutler C., Heaslip V. (2021). Dementia as zeitgeist: social problem construction and the role of a contemporary distraction. Sociol. Res. 26, 309 – 325. doi: doi:10.1177/1360780420929033
  46. Peters M. D. J., Godfrey C., McInerney P., Khalil H., Larsen P., Marnie C.. (2022). Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synthesis, 20, 953 – 968. doi: doi:10.11124/JBIES-21-00242
  47. Phoenix A. (2006). Interrogating intersectionality: productive ways of theorising multiple positioning. Kvinder Køn Forsk. 15, 21 – 30. doi: doi:10.7146/kkf.v0i2-5393.28082
  48. Phoenix A. (2011). “Psychosocial intersections: contextualising the accounts of adults who grew up in visibly ethnically different households,” in Framing Intersectionality: Debates on a Multifaceted Concept in Gender Studies. Farnham: Ashgate.
  49. Prins B. (2006). Narrative accounts of origins. Eur. J. Womens Stud. 13, 277 – 290. doi: doi:10.1177/1350506806065757
  50. Quijano A. (2000). Coloniality of power and eurocentrism in Latin America. Int. Sociol. 15, 215 – 232. doi: doi:10.1177/0268580900015002005
  51. Restrepo E. (2018). Coloniality of power. Int. Encyclopedia Anthropol. 12, 1 – 6. doi: doi:10.1002/9781118924396.wbiea2118
  52. Roes M., Laporte Uribe F., Peters-Nehrenheim V., Smits C., Johannessen A., Charlesworth G.. (2022). Intersectionality and its relevance for research in dementia care of people with a migration background. Z Gerontol. Geriatr. 55, 287 – 291. doi: doi:10.1007/s00391-022-02058-y
  53. Schmachtenberg T., Monsees J., Hoffmann W., van den Berg N., Stentzel U., Thyrian J. R.. (2020). Comparing national dementia plans and strategies in Europe – is there a focus of care for people with dementia from a migration background? BMC Public Health 20, 1 – 10. doi: doi:10.1186/s12889-020-08938-5
  54. Sherman A. D. F., Febres-Cordero S., Johnson K. B., Clark K. D., Klepper M., Duroseau B.. (2023). Intersectionality in nursing research: a scoping review. Int. J. Nurs. Stud. Adv. 5: 100155. doi: doi:10.1016/j.ijnsa.2023.100155
  55. Shippee T., Rosser B. R. S., Wright M. M., Aumock C., Moone R., Talley K. M. C.. (2024). Scoping literature review: experiences of sexual and gender minority older adults, with diagnoses of dementia, who use residential long-term services and supports. J. Appl. Gerontol. 43, 562 – 576. doi: doi:10.1177/07334648231213532
  56. Stites S. D., Velocci B. (2024). Sex, gender, sexual orientation, and more: sexual diversity in Alzheimer's research needs a new lens to achieve inclusive research and generalizable results. Alzheimer's Dementia Transl. Res. Clin. Intervent. 10: e12476. doi: doi:10.1002/trc2.12476
  57. Thimm V. (2025). Bringing Intersectionality to the core of social and cultural anthropology: scaling holistic intersectionality. Ethnos 90, 110 – 127. doi: doi:10.1080/00141844.2023.2226833
  58. Tobin Thomas C. S., Gutiérrez Á., Farmer H. R., Erving C. L., Hargrove T. W. (2023). Intersectional approaches to minority aging research. Curr. Epidemiol. Rep. 10, 33 – 43. doi: doi:10.1007/s40471-022-00317-5
  59. Vilor-Tejedor N., Danso S., Albanus R. D'. O., Billingsley K., Evans T. E., Yuanxi Lee L.. (2026). Advancing global dementia research through equity and inclusion. Alzheimer's Dement. 22: e71069. doi: doi:10.1002/alz.71069
  60. Voruz V. (2005). The politics of the culture of control: undoing genealogy. Econ. Soc. 34, 154 – 172. doi: doi:10.1080/0308514042000329379
  61. Wilkes R., Karimi A. (2024). What does the MAIHDA method explain? Soc. Sci. Med. 345: 116495. doi: doi:10.1016/j.socscimed.2023.116495
  62. Wong K. L. Y., Johnson G., O'Connor D. (2024). Living with dementia: exploring the intersections of culture, race, and dementia, stigma. Dementia 23, 1001 – 1020. doi: doi:10.1177/14713012241249796
  63. Zacher M., Brady S., Short S. E. (2023). Geographic patterns of dementia in the united states: variation by place of residence, place of birth, and subpopulation. J. Gerontol. B Psychol. Sci. Soc. Sci. 78, 1192 – 1203. doi: doi:10.1093/geronb/gbad045

Citation

Roes, M., et al. (2026). Mapping intersectionality in dementia care research: a decadal scoping review. Frontiers in Dementia, Volume 5. https://doi.org/
Received
Accepted
Published
Volume
5 - 2026

Copyright

Copyright © 2026 Roes, Laporte Uribe, Felding, Charlesworth, Müller, Berdai, Bhatt, Altinok and Peters-Nehrenheim.

License: https://creativecommons.org/licenses/by/4.0/

*Correspondence: Martina Roes

Article metrics

Views
0
Downloads
0
Citations
0
Shares
0

Related articles

Clinical TrialDevelopment of a multimodal health education module for dementia prevention in at-risk rural Indian elders: a SMRUTHI INDIA initiativeKritika Sharma, Aditi Dubey, Shubham Gupta, Kajal Fulara, Hina Narzari, Nilima Nilima, Sneha, Kamini, Sakshi Sharma, Varuna Sharma, Shikha Chaudhary, Phaniraj Vastrad, N. Priya Darshanraj, Sandip Bhattacharjee, Pradyut Datta, Gajraj Singh Shekhawat, Arnav Verma, V. Harshath Ajay, Jajur Rajappa Sandesh, Ambika Y. V., Bishakha Sen, Shalina Jamatia, Priyanka Kumari Meena, Hitesh Tiwari, Shaily Bhushan, Sagar P. M., Ripanjit Singh, Manish Acharjee, Vikram Raigar, Kalpna Sharma, Aishwarya Bhovi, Mailarappa Padiyappa Hooli, Shilpa K., Naveen M.R., Dipankar Deb, Pameli Jamatia, Pooja Sharma, Akhilesh Nagar, Tinku Yogi, Rishav Bhatia, Rishabh Gautam, Maroof Khan, Vaibhav Patil, Rajeev Aggarwal, Ashima Nehra, Kanika Vasudeva, Nimin Hafeez, Chanchal Goyal, Subarna Roy, Manish Barvaliya, Subrata Baidya, Shampa Das, P. K. Anand, Sunil K. Raina, Meenakshi Sharma, R. S. Dhaliwal, Abhik Sinha, Anu Gupta, Venugopalan Y. Vishnu, M. V. Padma SrivastavaGeneral CommentaryCommentary: Understanding how informal dementia caregiver networks are assessed in the literature: results from a scoping reviewMi-Kyung Song, Sudeshna Paul, Mary Beth HappOriginal ResearchUse of the Roadmap positive activity app in daily life among dementia caregivers: evidence of feasibility and acceptabilityKira S. Birditt, Yee To Ng, Lizbeth Benson, Allison Doroshewitz, Angela Turkelson, Noelle E. Carlozzi, Sung Won Choi