Understanding dementia in Filipino Americans: risk factors, research gaps, and the role of community-based participatory research.

Filipino Americans are the third-largest Asian American, Native Hawaiians, and Pacific Islander (AANHPI) group in the United States. Previous studies showed that they have high incident rates of Alzheimer's disease and related dementias (AD/ADRD) compared to other AANHPI groups. However, they are often aggregated into the "Asian" category in AD/ADRD research, masking distinct risk and mitigating factors. To date, no studies have directly explored AD/ADRD factors in Filipino Americans, a community that has unique characteristics from life experiences, immigration, historical and cultural context, and differential burden of genetic risk. In this perspective, we review known AD/ADRD risk and mitigating factors through the lens of the National Institute on Aging's Health Disparities Research Framework, spanning environmental, sociocultural, behavioral, and biological domains, and discuss their relevance to the Filipino American community. By identifying current knowledge gaps and contextualizing AD/ADRD risk and resilience through this framework, we aim to improve understanding of the complex, multifactorial pathways contributing to AD/ADRD outcomes across communities. Lastly, we discuss our experiences and strategies in the recruitment of Filipino Americans for AD/ADRD research studies, outlining challenges, successes, and future directions.