September is Healthy Aging Month and the beginning of Latinx Heritage Month, an important time to shine a light on the latest research around Alzheimer’s and dementia prevention for one of the highest affected populations.

The Latinx population aged 65 and older is projected to quadruple in the U.S. by 2060 and has the second-highest prevalence of Alzheimer’s disease. Brain health for this population is a rising public health crisis, for older Latinx adults living with Alzheimer’s and other dementias as well as the individuals and families who provide care on their behalf.

María P. Aranda, executive director of the USC Edward R. Roybal Institute on Aging and professor at the USC Suzanne Dworak-Peck School of Social Work, has dedicated her career to this emerging crisis. An internationally recognized scholar in the fields of social work, geriatrics and gerontology, Aranda is one of the most highly cited Latina scholars in dementia caregiving research in the U.S.  For her outstanding work to support and grow the next generation of researchers to address the formidable challenges of older Latinx adults living with dementia and those who care for them, Aranda has been honored with the 2022 James Jackson Outstanding Mentorship Award by the Gerontological Society of America. This distinguished honor recognizes individuals who have exemplified outstanding commitment and dedication to mentoring minority researchers in the field of aging.

“I had absolutely no academic or professional models at all,” Aranda said. “So, when I mentor people at different stages of their careers, and they see me in the position that I am in now, I want to make sure it’s a model that really resonates with them.”

Close to home, but another world

Although born just one mile from the USC Health Sciences campus, Aranda grew up in a world far from academia. She is the first of her generation to attend a four-year university.  During her childhood, Aranda was surrounded by older adults and developed an appreciation for their wisdom and humor early on.

“Older people have always opened up to me and talked to me with ease. I’m the beneficiary of their life stories, experiences and narratives,” Aranda said. “I got to hear a lot of secrets too, which kept me engaged and interested.”

As a first-generation U.S.-born Latina and advanced degree graduate, Aranda is not the traditional face of academia and research. Just seven percent of doctorates are awarded to those of Latinx descent, and an even smaller number of women pursue a career in academia and research, with fewer than one percent of Latinas earning a doctorate. To help bridge this racial disparity, Aranda dedicates a significant portion of her time to mentoring the next generation of scientists, professionals and community health workers.

One of the most impactful and far-reaching ways that Aranda has achieved this is through a National Institute of Aging-funded scholars training program on Alzheimer’s and dementia health disparities, that nurtures underrepresented researchers in the scientific workforce. The training was designed exclusively for 10 early-career investigators from diverse groups — including women, sexual and gender minorities, and racial/ethnic minoritized groups — from a wide range of disciplines, which Aranda says has generated over $32 million in grant funding for the continued work of its emerging scholars.

Aranda is also a strong proponent of integrating traditional Latinx wisdom into therapeutic practice and allowing it to guide treatment. Early in her career, she and a group of likeminded social workers, psychologists and marriage and family therapists formed a training salon called Calmecac de Aztlan en Los that met several times a month to discuss alternative healing approaches that were inclusive of Latinx traditions, and supported one another in developing programs and services that incorporated more culturally-sensitive methods.

Caring for the caregivers

Individuals living with neurodegenerative disorders such as Alzheimer’s are not the only ones impacted. Aranda says that 75 percent of family caregivers have no to minimal access to additional help beyond what basic health care provides. The impact on family caregivers can be extraordinary, often filling every need for their loved one, acting as social worker, primary care provider, case manager, attorney, financial affairs consultant, Uber driver and housekeeper. They are ‘on call’ 24 hours a day, frequently while juggling their own full- or part-time jobs.

“It’s not euphemistically called ‘caregiver burden,’ anymore” Aranda said. “There are very serious, direct impacts of caregiving on the health and mental health of family caregivers, especially when caring for people living with dementia. Caregivers have higher rates of anxiety and depression, mortality, financial stress and poor sleep. They can be at risk for developing dementia themselves.”

Aranda has made caring for caregivers a primary focus of her research. She developed Grupo Siempre Viva, the first Spanish-language support group for families affected by Alzheimer’s, and the first care models for Latino families in Los Angeles County — the El Portal Latino Alzheimer's Project, and Programa Esperanza — for individuals affected by Alzheimer’s and depression, respectively.  She has served on several consensus committees for the National Academies of Sciences, Engineering, and Medicine on the geriatric workforce in mental health and substance use disorders, family caregiving to older adults with functional limitations, financial capacity determination among Social Security Administration beneficiaries, functional assessment for adults with disabilities, and evidenced-based interventions for persons living with dementia and their care partners. In 2019, Aranda was appointed by California Governor Gavin Newsom to serve on the Governor's Task Force on Alzheimer’s (Disease) Prevention and Preparedness, chaired by Maria Shriver, to recommend statewide standards and programs on behalf of the close to 700,000 individuals living with dementia in California. She recently received a large research award for her study “Leveraging New and Existing Data to Evaluate the Efficacy and Effectiveness of Caregiver Interventions,” which will test community-based dementia caregiver interventions for their effect on caregivers with regard to affective symptoms, reactivity to memory and behavioral problems and skill-building.

Aranda recently piloted a professional training program for licensed clinical social workers, which she also co-developed, entitled Supporting Family Caregivers When the Diagnosis is Dementia. This continuing education workshop offered by USC Social Work was underwritten by alumna Loretta Huahn, MSW ‘61, and is the first of its kind at a school of social work. Aranda hopes to make it a regular series to help spotlight the spectrum of needs among family caregivers of people living with dementia.

Aranda is committed to busting stereotypes related to aging and dementia. She says that ageism is the last acceptable “ism” where society sanctions biased and discriminatory behavior toward older adults. People do not realize their own biases even as they automatically question older adults’ physical and mental capabilities, and thus reinforce life-limiting, stereotypical ideas about older adults.

“People will make statements they wouldn’t necessarily make about a middle-aged or a younger person,” Aranda said. “Instead of questioning your productivity and your cognitive capacity just because you’ve reached some magical number, we should be looking at what is your next life chapter and what else you have to contribute.”

If you are a caregiver for a person living with Alzheimer’s or other dementia and interested in participating in an upcoming caregiver study, please contact Dr. Aranda at aranda@usc.edu.