Conversation with Dr. Jaime Perales Puchalt, University of Kansas

Addressing Disparities in Dementia Detection and Care for Latino Families

NIMHD’s Conversations with Researchers Advancing Health Equity

September 15 to October 15 is National Hispanic American Heritage Month. As we celebrate the significant contributions to America—from its history through present day—by people who represent Hispanic and Latino communities, we recognize researchers who are promoting health equity through their work to advance the science of minority health and health disparities.

Meet Jaime Perales Puchalt, Ph.D., MPH, principal investigator in minority health and health disparities research.

Dr. Jaime Perales Puchalt

Dr. Jaime Perales Puchalt is an assistant professor at the University of Kansas Alzheimer's Disease Research Center. Among his many roles, he is the Co-Director of Juntos for Brain Health, a partnership to eliminate dementia disparities among Latino communities via research, education and service. His research spans Spain, England and the United States, and he has collaborated with teams from other countries in the European Union and the Americas.

His research covers dementia disparities for Latino communities, including his NIMHD-funded research focused on disparities in dementia care, and the risk of dementia and mild cognitive impairment among sexual and ethnoracial minority groups.

Dr. Perales Puchalt holds a Ph.D. in biomedicine and public health and an MPH in public health from the University Pompeu Fabra, Barcelona. He also has a MSc in psychology from the University of Valencia, Spain.

Q & A with Dr. Perales Puchalt

What inspired you to become a researcher in minority health, health disparities, and health equity?
As a teenager, I internalized my family’s motto, “don't do to others what you don't want done to you,” a quote attributed to Confucius. In the U.S., Dr. King’s words resonated with me as well, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.” These words motivate me because I’m aware I’ve been entrusted with a career that allows me to reduce health disparities and transform the lives of populations.

My interest in social justice turned into research when I volunteered to investigate immigration stress among Latin American people in Valencia, my hometown. Later, during my Master’s in Public Health program, I took classes about health disparities and learned about the social determinants of health. From then on, my research focused on aging disparities tied to social class and gender. When I moved to Kansas, I honed my focus to health disparities experienced by Hispanic and Latino communities.

What is your research goal, purpose and aim?
My long-term goal is to establish an independent research program to address disparities in dementia experienced by Latino communities.

Compared to non-Latino White populations, Latino populations are more likely to have dementia, less likely to have it detected and treated, and less likely to receive caregiver support. The underrepresentation of Latino populations in dementia research is exacerbating these disparities.

How is your work advancing health equity? Are you seeing specific changes in the health disparities experienced by particular communities or groups?
My current research focuses on understanding dementia care disparities that Latino groups experience and developing interventions to eliminate those disparities. Primary care providers often lack the tools and means to diagnose and provide support to Latino families with dementia. For example, few providers use dementia screening tools, and even fewer use tools validated for Latino populations and U.S. Spanish-speaking persons. Primary care providers are frequently the only health care providers who will see Latino families. For this reason, we’re providing the training and tools necessary for primary care providers to detect and treat dementia in culturally appropriate ways.

As a result of this research, not only has the number of Latino families with dementia being detected in primary care increased, but access to caregiver support among Latino families has also increased via text messages and phone calls in their language.

From the research you are doing, what has surprised you about the discoveries from your lab and its impact?
Improving remote dementia caregiver support has been a gamechanger. Latino families are grateful they can participate in caregiver support (and assessments) from their homes. Remote modalities highly accessible for Latino families make recruitment, retention, and engagement with interventions significantly easier than in-person interventions.

During the COVID-19 pandemic, I observed how lockdowns influenced the decline in physical, mental, and cognitive functioning among Latino individuals with dementia and the mental impact on caregivers. However, I also saw how my remote interventions helped Latino families with dementia at a time when in-person meetings (especially groups) were simply unavailable.

How do we encourage the next generation of scientists?
The funds NIMHD and NIH have allocated for health disparities and minority health research and related policies over the last few years sends an important message. Health disparities and minority health are important research fields. You can devote your life to it.

What do you envision as the future of minority health, health disparities, and health equity research?
Ultimately, I would like to see this research no longer necessary because health disparities no longer exist. That’s utopic, but I think it’s good to keep that objective in mind.

More realistically, I see researchers increasing their focus on intersectionality, as we gain more fine-grained knowledge about different groups. I also think we will build an increasing number of interventions to support multiple levels of society. Implementation science is also going to play an important role. We know there are interventions to improve the quality of life for people with dementia and their families. We also must consider the day that we find a cure for Alzheimer’s. How do we implement these so we all have access and can benefit?

Page updated September 13, 2022