Making time for brain health: recognising temporal inequity in dementia risk reduction.

Abstract

Time is an under-recognised social determinant of brain health, and is potentially as important as education or income for dementia risk. Temporal inequity refers to the unequal distribution of discretionary time owing to structural conditions shaping daily life. Temporal inequity encompasses insufficient time for rest, misaligned biological rhythms, fragmented leisure, and the encroachment of work or digital demands into personal time. Time poverty is a measurable manifestation, denoting insufficient time for brain health, disproportionately affecting structurally disadvantaged populations and exacerbated by performance-driven cultures. Although evidence for modifiable risk factors of dementia, such as sleep, physical activity, nutrition, and social engagement, is strong, adopting healthy behaviours requires time. In this Personal View, we integrate insights from epidemiology, neuroscience, and time-use research to argue that addressing temporal inequity is essential for brain health and dementia risk reduction. We call for temporal justice through research and policies that recognise time as both a resource and a site of inequity in ageing and dementia. Accordingly, we outline future research directions, including the development of metrics for temporal inequity, longitudinal studies linking time-use patterns to brain health outcomes, and intervention research to evaluate policies that expand equitable access to time.