Time has been identified as an under-recognised social determinant of brain health, potentially as important as education and income.
Time – or the lack of it – could be a missing link in dementia prevention, according to research from UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA).
Temporal inequity – the unequal distribution of time across different groups in society – may significantly undermine people’s ability to reduce their risk of dementia.
“Up to 45% of dementia cases worldwide could be prevented if modifiable risk factors were eliminated,” said lead author and social determinants of health expert Associate Professor Susanne Röhr.
“However, many people simply don’t have the discretionary time to exercise, rest properly, eat healthily or stay socially connected. This lack of time – what we call ‘time poverty’ – is a hidden barrier to dementia risk reduction.”
Structural conditions, including long working hours, caregiving responsibilities, digital overload, and socioeconomic disadvantage, create time poverty that disproportionately affects already vulnerable groups.
This, in turn, compounds existing health inequities and limits opportunities for brain-healthy behaviours.
Recognising time as a social determinant of health requires a fundamental shift in how dementia prevention is approached, said CHeBA Co-Director and co-author Professor Perminder Sachdev.
“Brain health policy and research have focused heavily on individual behaviour change. But unless people are given the temporal resources to act on these recommendations, we risk leaving behind those who need it most.
“Just as governments act on income inequality, we need to act on temporal inequity.”
Temporal justice
The researchers call for policy and workplace reforms to support temporal justice which are measures that protect and redistribute time so that everyone can access the opportunity for brain health.
Examples include flexible working arrangements, rights to disconnect, affordable childcare, investment in public transport and urban planning that reduces commuting times.
Future research must also capture how much time is realistically needed for brain care, said co-author Associate Professor Simone Reppermund.
“Our evidence suggests that at least 10 hours per day are required just for essential brain health activities such as sleep, meals, physical activity, and social interaction.”
“For many, especially those in disadvantaged or caregiving roles, this simply isn’t achievable under current conditions. Addressing time poverty is therefore essential if we are serious about preventing dementia.”
The authors argue that time must be recognised as both a resource and a site of inequity, urging governments, researchers and communities to integrate temporal justice into dementia prevention strategies.
The research, published in The Lancet Healthy Longevity.
