SEQUINS Hall of Fame: James E. Galvin, MD, MPH, on Advancing Inclusive Dementia Detection and Care

The Society for Equity in Neuroscience (SEQUINS) will honor several leaders in neurologic care and research during its upcoming annual conference (May 14^th) through the organization’s Hall of Fame initiative, which recognizes individuals who have made lasting contributions to advancing equity in neuroscience. Among this year’s honorees is James E. Galvin, MD, MPH, Professor of Neurology and Psychiatry & Behavioral Sciences at the University of Miami Miller School of Medicine.

Galvin serves as Chief of the Division of Cognitive Neurology, Founding Director of the Comprehensive Center for Brain Health, and Director of the Lewy Body Dementia Research Center of Excellence at the University of Miami. Throughout his career, his work has focused on Alzheimer disease, Lewy body dementia, healthy brain aging, and improving access to culturally relevant cognitive assessment and dementia care across diverse populations.

In a recent Q&A with NeurologyLive^®, Galvin discussed the personal experiences that shaped his interest in dementia care, the ongoing barriers to equitable cognitive assessment, and how clinicians can better integrate equity-focused approaches into routine neurologic practice. He also reflected on the significance of being recognized as a SEQUINS Hall of Fame honoree at this stage of his career.

NeurologyLive: What does being named a SEQUINS Hall of Famer mean to you at this stage of your career?

James E. Galvin, MD, MPH: I am deeply honored to named to the SEQUINS Hall of Fame. This has been a lifelong interest, and I have been fortunate to have to opportunity and support to pursue the important questions about how to provide culturally relevant and appropriate assessments that will serve all Americans to provide early detection and treatment in order to eliminate health inequities

What inspired your focus on cognitive disorders and dementia care, and how has that focus evolved?

My first real exposure to cognitive disorders and dementia care revolved around my grandfather who developed Parkinson’s disease in my junior year of high school and later developed Lewy body dementia. This greatly shaped my focus of dementia research and care. As I moved forward in my career, I became the Outreach Core leader for the ADRC engaging diverse communities and saw firsthand the impact of health inequities on brain health. At the same time, my in-laws who were from Antigua developed Alzheimer's disease (mother) and Vascular dementia (father). Despite my experience and expertise, it was very hard to get them the care and resources they needed. For me, this has not just been a professional activity, but a personal battle.

Your work has emphasized improving detection and diagnosis—how does this intersect with equity in brain health?

Our goal, and the goal of all such research, should be to position individuals to improve their brain health and reduce their risk of dementia. While I will always be there to diagnose and treat individuals with the respect they deserve, but I would prefer to be out of business because I was able to improve brain health and health outcomes for all Americans so that Alzheimer’s disease and related disorders would be a rare occurrence.

What barriers still exist in equitable access to cognitive assessment and dementia care?

Our research has focused on early social and structural determinants of health and how these position individuals to be at potential disadvantage for medical comorbidities in midlife that increase their risk Alzheimer’s disease and related disorders in late life. Just waiting to provide early detection is a missed opportunity. However, without culturally resonant and relevant instruments that can detect risk factors and the earliest features of Alzheimer’s disease and related disorders across all populations, we cannot move the needle forward.

How can clinicians better integrate equity-focused approaches into routine neurologic practice?

There are a number of thoughts here. We have focused on having a representative collaborative practice reflective of the communities we serve and provide comprehensive services. Not just clinical diagnosis and treatment, but health coaching, psychotherapy, advanced care planning, and caregiver support. These services are often not available to many minoritized or low-income communities – we make them available to everyone.Replicating and disseminating similar models would increase equity.