Using faith to generate theory, population data to test it, and both to design inclusive dementia prevention

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By Dr Sanda Ismail

Dementia is often framed as a biomedical problem, but my research starts from a different place. It begins with a simple observation: people do not live, age, or make sense of health in isolation. They do so within communities, cultures, belief systems, and social structures that shape behaviour, meaning, and wellbeing across the life course.

Over the past few years, my work has focused on faith and community environments, not simply as settings for intervention, but as sources of insight. These contexts help generate theory about how social participation, meaning, and identity shape brain health. I then use large population datasets to test these mechanisms at scale. Finally, I bring both strands together to design more inclusive approaches to dementia prevention and support.

Brain health is shaped not only by biology, but by the social and psychological environments in which people live

Faith communities as engines of theory, not just delivery sites

Faith communities are often treated instrumentally in public health: useful channels for disseminating messages or recruiting participants. My research takes a different view. Faith settings are rich social systems where people gather regularly, form identities, share values, build trust, and engage in meaningful routines. These features offer clues about how social environments might protect brain health.

In many faith contexts, including mosques and Muslim community organisations, older adults are embedded in dense social networks. They take on roles, maintain routines, and participate in practices that provide structure, purpose, and belonging. These are not just spiritual activities; they are social and psychological exposures with potential implications for dementia risk.

Rather than asking whether religion itself is “protective”, my work asks a more precise question: what features of faith-based participation might shape exposure to modifiable dementia risk factors and could those features be relevant beyond faith settings?

Community participation, shared identity, and belonging are powerful social exposures that may influence dementia risk

Testing mechanisms using population data

To move beyond description, I turn to large-scale epidemiological data. Using the English Longitudinal Study of Ageing (ELSA), my analyses examine how modifiable dementia risk factors, such as depression, loneliness, physical inactivity, and cardiovascular conditions, are distributed across faith and non-faith groups.

What emerges is not a simple story of advantage or disadvantage, but a patterned one. Faith communities are heterogeneous, yet many exhibit social cohesion, routine participation, and collective identity that are associated with lower exposure to certain psychosocial risks. These patterns suggest that dementia prevention is shaped not only by individual choices but by the social environments in which those choices are made.

This is where large cohorts matter. They allow us to test whether ideas generated in community contexts about belonging, meaning, and participation hold when examined longitudinally, across populations, and over time.

Meaning in life as a pathway to cognitive health

A closely related strand of my work focuses on meaning in life as a psychosocial pathway to healthy cognitive ageing. Using longitudinal ELSA data, I found that higher meaning in life is associated with a lower risk of developing cognitive frailty, an early and potentially reversible state combining physical frailty and mild cognitive impairment.

Importantly, this relationship appears to operate through mechanisms such as reduced depression and loneliness, and possibly through enhanced cognitive reserve. While meaning in life is deeply personal, it is often cultivated through social roles, moral frameworks, spirituality, and contribution to others, elements that are especially salient in faith and community settings.

These findings reinforce a central insight: dementia prevention may depend as much on purpose and belonging as on physical health behaviours.

Understanding “what works, for whom, and why”

To integrate these strands, I am undertaking a realist synthesis examining how faith-based settings influence dementia risk awareness and management. Rather than asking simply “what works”, realist methods ask: what works, for whom, in what contexts, and through which mechanisms? This evidence base will help explain why faith contexts can be powerful and where their limits lie.

Designing inclusive prevention: the Muslim Dementia Recovery College

The most applied expression of my work is the Muslim Dementia Recovery College (M-DROC). Co-designed with people living with dementia, carers, imams, clinicians, and community organisations, the project translates theory and evidence into practice.

The aim is not to “add culture” to existing models, but to build learning and support grounded in Islamic values such as compassion, dignity, family responsibility, and collective care. By doing so, the project seeks to reduce stigma, improve dementia literacy, and create culturally safe spaces for support and prevention.

A broader lesson for dementia prevention

Faith communities have helped generate theory, population data have tested mechanisms, and co-design has translated evidence into inclusive prevention. As societies become more diverse, dementia research and public health must move beyond one-size-fits-all models and recognise cultural identity as a resource rather than a barrier. Dementia prevention begins long before old age, and it starts where people already live: in communities that provide meaning, structure, and connection.

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