The review, led by Martina Roes of the German Center for Neurodegenerative Diseases and colleagues across Europe, set out to answer a deceptively simple question: which intersectionality frameworks have actually been applied in dementia care research published between 2015 and 2025? The team followed Arksey and O’Malley’s six-stage scoping review methodology, extended with PRISMA reporting guidelines, and searched six databases—PubMed, PsycINFO, Scopus, CINAHL, Embase and Web of Science. Their search string combined terms for dementia and Alzheimer’s disease with terms for intersectionality, structural inequality, migrants, minority groups and social determinants, and then with care-related and framework-related vocabulary. From 870 retrieved articles, 320 duplicates were removed, 550 went through title and abstract screening, and 110 survived to full-text review. Thirteen articles ultimately met the inclusion criteria, which required a clear link to dementia care, an intersectional framework or intersectional focus, and publication in English or German.

The framework counts tell their own story. Crenshaw’s original concept was cited in eight of the included publications, McCall’s framework in seven, and Hankivsky’s and Collins’s frameworks in three each. McCall’s contribution is particularly important for the technical architecture of the field: she distinguished anti-categorical, inter-categorical and intra-categorical approaches to studying inequality. Anti-categorical analysis questions the very categories society uses; inter-categorical analysis compares patterns across groups defined by existing categories; and intra-categorical analysis zooms in on a single marginalized intersection to examine it in depth. Hankivsky’s Intersectionality-Based Policy Analysis extends the lens to power relations and operational structures across micro, meso and macro levels, while Collins defines intersectionality as a critical social theory built on constructs such as relationality and complexity. Bowleg’s public health perspective, which emphasizes how interlocking systems of power and oppression shape lived experience, rounds out the theoretical toolkit.

Why does this matter for dementia specifically? The review’s authors argue that dementia is not only a neurodegenerative disease but also a social construct—a label that shapes how people living with dementia are treated by society. Experiences such as stigma, the removal of autonomy and citizen rights, and the dismissal of personhood and decision-making capacity suggest that the diagnosis itself interacts with social positioning. The experiences of people living with dementia are heterogeneous and differ at the intersection of axes of identity such as age and ethnicity, social geography such as where one lives, and societal context such as income. Analyzing these complex individual experiences through an intersectional lens can uncover inequalities that would otherwise remain invisible within the health care system.

The target groups of the included studies clustered around migrants, ethnicity and race, and sex and gender. One qualitative study of migrant family carers used life-story interviews and shadowing to show how gender, migration trajectories, class and legal status interact to distribute and constrain care roles—revealing that migrant women more often work as unpaid carers while navigating precarious employment and restrictive welfare services. Another study applying Collins’s framework to ethnographic observations in UK acute hospitals found that privilege and marginalization are products of power dynamics between identity axes and institutional regulations, with institutional power systems driving inequalities in whether care needs are even recognized. A Canadian interview study of immigrants living with dementia and their caregivers identified how racism, cultural norms, immigration histories and cognitive impairment interact to produce layered stigma, social exclusion and barriers to support.

Quantitative work appeared too, though in limited form. A logistic regression analysis of informal caregivers found that ethnicity and gender intersections yield distinct caregiving burdens, calling for tailored interventions. A US study of geographic patterns of dementia used a life-course and social health-disparity lens to show that disadvantage is embedded within place of residence, place of birth and subpopulation groupings. And a selective literature review on Black female Americans with Alzheimer’s disease examined how social and biological factors—poverty, education, discrimination, allostatic load, vascular risk factors, access to care and under-representation in trials—intersect with female biological sex and Black American race to increase disease risk. Studies of sexual and gender minority older adults with dementia found compounded discrimination at individual, interpersonal and institutional levels, with risk magnified for those who are also transgender, racially minoritized or HIV-positive, and with facility and staff knowledge often remaining inadequate.

Here is the review’s most striking technical finding: none of the thirteen included articles directly addressed power dynamics with a specific intersectional focus. The authors searched each study for mentions and descriptions of power relations between axes of identity and the social or health care system, and found that detailed analysis of how power operates within the healthcare system or society was mostly not conducted—or only mentioned as a need. Most studies treated race, ethnicity, migration status, sex, gender, age or socioeconomic status more as separate covariates or descriptive subgroups than as interlocking categories embedded in systems of power. The review distinguishes inequality, an unequal distribution of resources, from inequity, which refers to unfairness and injustice produced by human behavior, social structures and policies—and is therefore avoidable. The included studies documented inequities in access to diagnosis and services, in care burden, in double discrimination, and in institutional ignorance, but rarely traced them back to the power structures that produce them.

The authors identify four research gaps: underrepresentation of minority groups in dementia care research, a primary focus on intersections rather than underlying power dynamics, unclear methodology for how frameworks are applied, and undefined theoretical backgrounds. They also call for critical reflection on the coloniality of power and its ongoing impact on knowledge production—including Eurocentric diagnostic norms, care models, research priorities and dementia strategies in Europe. Without this reflection, psychosocial interventions will not be tailored to care recipients with intersecting marginalized identities, and assessments will lack validation for diverse populations. The review notes that almost all included articles combined at least two intersectionality frameworks, but methodological details on how the frameworks were operationalized were missing—with one exception, a study theorizing intersectionality and cultures of control in acute hospital settings.

The recommendations are concrete. Methodologically, the authors urge moving beyond simple group comparisons toward analyzing the combined impact of overlapping intersections—for example, living in a rural and poor neighborhood with a biography of migration—on patient-related outcomes. They highlight MAIHDA, multilevel analysis of individual heterogeneity and discriminatory accuracy, as a quantitative intersectional approach to socio-demographic inequalities, alongside mixed-method designs that capture the how and why of intersecting experiences. Structurally, they call for analyzing how structural determinants impact disparities in dementia incidence, prevalence, diagnosis, treatment and care, including the double jeopardy faced by people holding multiple marginalized identities. And in research design, they recommend rethinking recruitment strategies for populations facing high levels of inequity—LGBTQI+ communities, ethnic minority groups, indigenous communities—through community-based participatory research, which ensures that research topics are relevant to marginalized communities, and developing longitudinal datasets to understand structural determinants such as neighborhood deprivation.

As a first attempt to critically analyze the application of intersectionality frameworks in dementia care research, the review offers a clear benchmark for what genuine intersectional power analysis would require: an explicitly defined system such as sexism or migration regulations that interlocks with observed outcomes of oppression; a connection between individual experiences such as stigma and exclusion and organizational norms, admission practices, national dementia plans and professional guidelines; and an understanding of identity axes and power dynamics as historically situated and relational. The authors believe the recent increase in intersectional adoption will enable research that analyzes not only social categories but also the dynamics and relations between them, embedded in specific context and produced by their conjunction. For a field built on the principle that real lives are too complex for single-lens analysis, that is the direction the evidence now points.

Subject of Research: Use of intersectionality frameworks in dementia care research over the past decade

Article Title: Mapping intersectionality in dementia care research: a decadal scoping review

Article References: Roes, M., Laporte Uribe, F., Felding, S. A., Charlesworth, G., Müller, N., Berdai, S., Bhatt, J., Altinok, K., & Peters-Nehrenheim, V. (2026). Mapping intersectionality in dementia care research: a decadal scoping review. Frontiers in Dementia, 5, Article 1779670. https://doi.org/10.3389/frdem.2026.1779670

Image Credits: AI Generated

DOI: 10.3389/frdem.2026.1779670

Keywords: dementia, dementia care, intersectionality, scoping review, health disparities, power dynamics, health equity, migrants, sex and gender, Crenshaw, research gaps, caregiving

The theoretical engine of the study is a framework borrowed from philosophy and migration studies: the tactic–strategy continuum, developed by De Certeau and elaborated for migrant populations by Sereke and Drzewiecka. Strategies, in this account, belong to the powerful—migration offices, welfare agencies, employers, refugee centres—institutions that set the terms of access to housing, work, healthcare and language education. Tactics belong to those who must build their lives within frameworks designed by others. The researchers treat tactics and strategies not as a binary but as points on a continuum of action, and they ask what everyday ‘techniques’ women deploy to overcome or sidestep barriers, negotiate state integration requirements, and counter racist exclusions. The answer, they find, is written into the smallest details of daily life.

The study’s second analytical lens is intersectionality, understood through the work of postcolonial feminist scholar Chandra Talpade Mohanty. Rather than treating gender, ethnicity, religion, age, disability, education and legal status as separate variables, the researchers examined how these dimensions overlap and compound one another in concrete situations. A highly educated physician from a conflict zone, for instance, faces a very different set of barriers than a woman with limited literacy, even when both hold the same temporary residence permit. The framework also foregrounds solidarity among women as a form of resistance, a theme that turned out to be central to the findings.

Between August 2021 and October 2025, the team conducted semi-structured qualitative interviews lasting 45 to 90 minutes, in German, English, Swedish, Dari and Farsi, with interpreters and trained cultural brokers supporting some sessions. Participants ranged from 21 to 49 years old and lived in cities, where access to language courses, public transport and jobs is better than in rural areas but where bureaucracy and competition for housing and work are fiercer. The interviews were analysed using reflexive thematic analysis, with intersectionality applied as a critical reflexivity tool across all six analytical steps. The researchers were explicit about their own positionality: the first author is a migratised occupational therapist with roots in Pakistan, and several co-authors have personal histories of exile and voluntary migration, including one who grew up during Chile’s dictatorship and later worked with survivors of human rights violations.

The analysis produced four themes, and the first captures the emotional terrain on which everything else unfolds: moving between uncertainty and hope. Participants described waiting years for residence permits and language courses, living in a liminal state one woman called being ‘lost in the woods’, torn between countries, ‘not there and not here at the same time – like a ghost’. One participant, Amira, waited more than three years for a permit and access to a German course while experiencing severe depression: ‘No place to live, no work, no language.’ The researchers interpret this enforced waiting as a strategic exercise of power—what other scholars call slow violence and necropolitics, the bureaucratic machinery that makes some lives wait indefinitely. Against this, the women’s tactics were strikingly concrete. One participant, Naima, denied language classes in 2016, wrote new German words on her wall to memorise them and raised her hand declaring ‘I want, I want’ whenever anyone at the refugee centre mentioned work. Another summed up her survival philosophy in five words: ‘Information is more than money.’

The second theme, disrupted narratives, documents how migration severs the story a person tells about her own life. Amira, a former specialist physician, described needing to ‘wear my white coat’ but being unable to practise medicine in Germany, working instead as a nursing assistant and feeling ‘like a small human’. Professional validation processes took years, and the researchers note that high qualifications can paradoxically make labour market re-entry harder, because the gap between previous status and available work is so wide. Other participants described precariousness rooted in family structure: financial dependence on partners, full responsibility for childcare, and no personal time or independent social network. One woman relied on her partner for housing and finances while unable to work as a midwife, describing herself as feeling like a ‘small child’—a metaphor the researchers read as infantilisation produced by oppressive living conditions.

The third theme is the study’s most vivid: nature-based occupations as tactics of freedom. Bicycling emerged as far more than transport. For women who had been barred from cycling in their countries of origin by gender restrictions, learning to ride in Germany or Sweden carried symbolic weight connected to gender equality, independence and health—one participant said she had to bicycle every day ‘because of bad thoughts. I have nightmares.’ The researchers situate this within a long history: the bicycle has been a ‘tool for liberty’ in women’s rights movements since the late nineteenth century. Gardening played a parallel role. One participant rented an allotment where her family could simply be together in peace; another claimed a patch of green in her neighbourhood to plant a vegetable from home, creating a living link between her past and present. The researchers interpret these cultivated spaces as ‘gaining territory’—small, physical reversals of the power imbalance that otherwise defines displaced women’s lives.

Solidarity, the fourth theme, operates at a different scale. Participants volunteered in NGOs supporting refugee women, counselled peers on breast cancer screening and contraception, explained how the German and Swedish systems work, and taught other women to ride bicycles. Naima, who lives with a disability herself, declared: ‘No matter if I get money or not, I want to help the women.’ Her volunteering made her more independent and strengthened her position within dominant social structures, even though it brought no economic stability. Another participant recalled the moment her sense of self shifted on arriving in Europe: ‘I am in Europe, I am not just a housewife anymore.’ Drawing on Mohanty’s account of cross-cultural feminist solidarity, the researchers argue that these practices are not merely mutual aid but forms of resistance to structural violence—collective occupations that counteract the absence of state and institutional initiatives enabling a good life for displaced women.

The methodological choices deserve attention because they shape what the study can claim. The team used information power rather than saturation to justify the sample size, conducted analysis meetings guided by critical reflexivity, and evaluated quality against Tracy’s eight criteria for excellent qualitative research, including sincerity, resonance and meaningful coherence. Interpreters were matched to participants by sex and ethnic background, and every participant received a follow-up phone call days after her interview, along with contact details for psychosocial support networks—a safeguard reflecting the interviewers’ therapeutic experience with trauma. The long data collection window, stretching across election cycles, pandemic restrictions and shifting migration policies, is framed as a strength, because it captured how political change altered participants’ everyday conditions in real time.

The implications reach beyond academia. The authors argue that occupational therapists—health professionals who specialise in enabling meaningful daily activity—are uniquely positioned to support displaced women, but only if they understand everyday life as tactics and strategies in motion, shaped by intersecting power dynamics. Rather than treating a client’s difficulty attending a language course as an individual deficit, a therapist applying this lens would ask which structural barriers, gendered expectations and legal constraints are at play, and might work with the tactics women already use: cycling groups, gardening projects, solidarity networks. The researchers go further, insisting that practitioners must become allies and advocates rather than reproducing existing power imbalances in clinical settings. In a European policy climate marked by stricter border controls and the new EU Asylum and Migration Pact, the study is a reminder that integration is not something that happens to people—it is something people actively, ingeniously do, one bicycle ride, one planted seed and one act of solidarity at a time.

Subject of Research: Intersectional power dynamics and everyday occupations among women with experiences of forced migration in urban Sweden and Germany

Article Title: Tactics and Strategies Operating in Everyday Life Among Women with Experiences of Forced Migration

Article References: Scheer, S., Asaba, E., Buerk, T., Guerrero, M., & Mondaca, M. (2026). Tactics and Strategies Operating in Everyday Life Among Women with Experiences of Forced Migration. Scandinavian Journal of Occupational Therapy, 33(1), Article 9. https://doi.org/10.1007/s44474-026-00011-5

Image Credits: AI Generated

DOI: 10.1007/s44474-026-00011-5

Keywords: forced migration, refugee women, intersectionality, occupational therapy, power dynamics, solidarity, bicycling, gardening, social participation, qualitative research, Sweden, Germany

The study examined the SALIENT consortium, a UK research programme funded by the Economic and Social Research Council, part of UK Research and Innovation, with additional support from the government’s Evaluation Accelerator Fund, the Department for Environment, Food and Rural Affairs and the Food Standards Agency. SALIENT’s ambition was explicitly translational: rather than conducting research in isolation and hoping policymakers would eventually take notice, the consortium set out to co-design, implement and evaluate public-facing food system interventions with government partners and food system stakeholders, targeting improvements in both health and sustainability while maintaining affordability and commercial viability. In total, forty organisations engaged with the consortium, and eight of those progressed far enough to deliver and evaluate a combined ten interventions.

To understand how and why this engagement process worked for some organisations and faltered for others, the research team, led by Sarah Shaw of the University of Cambridge’s MRC Epidemiology Unit and the University of Southampton, together with colleagues from the London School of Hygiene and Tropical Medicine, the University of Hertfordshire, the University of Liverpool and the University of Oxford, conducted a qualitative evaluation grounded in theory-based evaluation principles. The methodological approach is worth unpacking. Rather than simply asking participants whether they enjoyed the collaboration, the evaluators first constructed a theory of change, a formal description of the causal pathway through which the SALIENT process was expected to produce its intended outcomes. This artefact then served as an analytical scaffold against which the interview data could be interpreted, allowing the team to identify precisely where the assumed mechanisms of change held up and where they broke down.

The evidence base for the evaluation consisted of thirty-eight semi-structured interviews with three categories of participants: government partners, academic researchers and food system representatives. Interview transcripts were subjected to thematic analysis, a systematic qualitative method in which researchers code the data, group codes into candidate themes, and refine those themes iteratively until they capture the patterns running through the corpus. By interpreting the resulting themes in relation to the theory of change, the evaluators could trace not just what participants experienced but why the engagement process unfolded as it did, a distinction that matters enormously for anyone planning to replicate this model of collaborative research.

The first major finding concerns fragmentation. Participants described a food system landscape in which existing health and sustainability actions were scattered, disconnected and often duplicative, shaped by the differing priorities, agendas and constraints of the stakeholders involved. A local authority might be focused on food poverty, a retailer on supply chain resilience, a regulator on safety standards, and a researcher on generating generalisable evidence. None of these agendas is wrong, but their misalignment means that even well-intentioned initiatives can pull in different directions, dissipating resources and momentum. The evaluation suggests that this fragmentation is not merely an administrative nuisance but a structural barrier that any cross-sectoral collaboration must confront from the outset, ideally through explicit governance arrangements that acknowledge and mediate competing interests rather than pretending they do not exist.

Power dynamics emerged as a second, closely related theme. The researchers found that stakeholder participation was strongest when the research aligned with the stakeholder’s core goals and offered tangible benefits, and weakest when it did not. This may sound obvious, but it carries a profound implication for how collaborative research is designed. Organisations do not donate their time, staff and data to academic projects out of altruism; they engage because the collaboration serves their institutional interests, whether that is access to evidence, reputational advantage, regulatory preparedness or practical problem-solving. Where the perceived benefit was diffuse or distant, engagement thinned out. The lesson for future consortia is that the value proposition for each partner must be articulated early and honestly, and that researchers who assume stakeholders will simply rally around the scientific mission are likely to be disappointed.

The third finding is perhaps the most methodologically provocative. Pragmatic co-design processes, in which interventions were shaped jointly with stakeholders to build trust and ensure feasibility, did indeed strengthen relationships and make implementation more realistic. But the evaluation found a hidden cost: interventions designed primarily for practical acceptability sometimes had limited potential to address the critical uncertainties in the evidence base. In other words, the very compromises that made an intervention deliverable in the real world could also blunt its scientific value, leaving fundamental questions about what works and why unanswered. This tension between rigour and relevance is a perennial problem in implementation science, but the SALIENT evaluation documents it with unusual clarity, showing that co-design is not a cost-free good but a balancing act in which the research questions themselves can be diluted.

Compounding this tension, the study found that academic processes were often perceived as misaligned with stakeholders’ practical needs. Timelines built around grant cycles, ethics approvals and publication schedules rarely map neatly onto the operational rhythms of businesses and local authorities, which must respond to market pressures and political timetables. Reporting requirements, evaluation protocols and the language of research governance can feel alien to partners whose expertise lies in logistics, catering or retail. The evaluation suggests that these frictions are not trivial irritations; they shape whether stakeholders remain engaged at all, and they can determine whether the evidence produced is actually usable by the people it is meant to serve.

So what should be done differently? The authors conclude that long-term government direction, stronger accountability and appropriate incentives are needed to foster meaningful collaboration between researchers and food system stakeholders. Short, project-based funding windows, they imply, are poorly suited to the slow work of building trust across sectors. Future partnerships, the study argues, should balance flexibility with rigour, invest in sustained relationships rather than one-off consultations, and establish strong governance, communication and evaluation processes early, before disagreements about priorities and power have a chance to fester. The goal is to generate robust, scalable evidence for meaningful food system change, and the evaluation makes clear that the machinery of collaboration is not a preliminary to that evidence but a determinant of it.

The significance of this work extends well beyond the UK food sector. Governments worldwide are grappling with diet-related disease, food insecurity and the environmental footprint of agriculture, and the prevailing policy fashion favours multi-stakeholder partnerships and co-produced solutions. SALIENT’s evaluation is a reminder that these fashionable formats are neither self-executing nor universally benign. They can build trust and deliver interventions, but they can also reproduce existing inequalities of power, fragment effort and soften scientific ambition. For researchers, the message is to design engagement around stakeholders’ real incentives and to protect the evidential core of their studies. For funders and governments, the message is that meaningful food system transformation requires patient investment in the unglamorous infrastructure of collaboration: governance, accountability and time. The study, which received ethics approval from the University of Cambridge Humanities and Social Sciences Research Ethics Committees and was published open access, offers a rare, honest blueprint for the difficult work ahead.

Subject of Research: Cross-sectoral collaborative research for food system transformation

Article Title: Conducting cross-sectoral collaborative research for food system transformation: learnings from a qualitative evaluation study

Article References: Shaw, S., Huse, O., Savory, B., Cooke, N., Thompson, C., Loopstra, R., Scarborough, P., Ogilvie, D., Cummins, S., White, M., & Adams, J. (2026). Conducting cross-sectoral collaborative research for food system transformation: learnings from a qualitative evaluation study. Health Research Policy and Systems. https://doi.org/10.1186/s12961-026-01540-y

Image Credits: AI Generated

DOI: 10.1186/s12961-026-01540-y

Keywords: food systems, cross-sectoral collaboration, co-design, qualitative evaluation, theory of change, stakeholder engagement, public health, sustainability, research policy, SALIENT consortium, power dynamics, evidence-based policy