Barriers and Breakthroughs in Aging Brain Health and Equitable Mental Healthcare Access

The field of aging psychiatry explores the complex interactions between biological, psychological, and societal factors that shape mental health in later life. Despite significant advances in understanding neuropsychiatric and neurodegenerative disorders -including Alzheimer’s disease and related dementias, Parkinson’s disease, and Lewy Body dementia - older adults continue to face persistent disparities in diagnosis, treatment, and care. Age-related brain changes interact with structural inequities in healthcare, from limited access to specialized mental health services to biases embedded within medical systems. While research has clarified many of the biological underpinnings of cognitive decline and psychiatric comorbidity, a substantial gap remains in translating these findings into equitable, person-centered care. Factors including healthcare design, technological literacy, medication burden, and stigma collectively hinder effective diagnosis, treatment, and support for the aging brain. Addressing these multidimensional challenges requires an integrative approach that links neuroscience, health policy, and the social determinants of mental health.This Research Topic examines both the barriers and the breakthroughs that define aging brain health and healthcare access for older adults. Central to this aim is understanding how biological and system-level factors (from medication regimens to policy design) interact to influence psychiatric and neurocognitive outcomes. Specifically, it seeks to explore how healthcare delivery models such as Medicare and Medicare Advantage plans, digital and electronic health infrastructures, and sociocultural biases including ageism, ableism, and mentalism (sanism) shape mental health trajectories in aging populations. By connecting clinical and translational advances to healthcare-accessibility frameworks, the goal is to foster integrative research that identifies risk and resilience factors and informs interventions that promote equity in mental health outcomes during aging. This Research Topic centers on the system-level, access, and social-determinant dimensions of aging brain health.To gather further insights into the interplay between aging, brain health, and healthcare access, we welcome articles addressing, but not limited to, the following themes:- Comparative analyses of Medicare and Medicare Advantage models in relation to mental healthcare access and quality.- The role of digital technologies and information systems as facilitators or barriers to psychiatric care for older adults.- Intersections of ageism, mentalism (sanism), and ableism in clinical decision-making and healthcare policy.- Evaluation of medications commonly prescribed to older adults that contribute to cognitive impairment and neuropsychiatric side effects (e.g., anticholinergic and sedative burden), including deprescribing strategies.- Equitable access to — and real-world translation and scaling of — advances in diagnosing and treating neurodegenerative disorders of later life, with particular attention to alpha-synucleinopathies (Lewy Body and Parkinsonian disorders) alongside Alzheimer’s disease and related dementias. Neurobiological mechanisms of the emotion–cognition interface in Alzheimer’s disease fall outside its scope.- Lifestyle, social-support, and system-level strategies (diet, physical activity, social connectedness, reduced treatment burden) that build resilience and prevent mental health decline in later life.- Integration of neuroscientific discoveries into equitable, scalable models of aging mental healthcare.Submissions encompassing multidisciplinary approaches—spanning neuroscience, genetics, psychology, psychiatry, health policy, and rehabilitation—are encouraged to contribute toward improving the mental health and quality of life of older adults worldwide. Topic editors: Charles M. Lepkowsky, Stephan Arndt, Stacey Carroll Source: https://www.frontiersin.org/research-topics/83896/barriers-and-breakthroughs-in-aging-brain-health-and-equitable-mental-healthcare-access