Evaluating Palliative Care Models For Neurodegenerative Conditions affecting Older Adults: Global Insights For Mexico (A realist review)

TY - JOUR

T1 - Evaluating Palliative Care Models For Neurodegenerative Conditions affecting Older Adults

T2 - Global Insights For Mexico (A realist review)

AU - Makita, Meiko

AU - Okamoto, Ikumi

AU - Paz Rodriguez, Francisco

AU - Alvarez del Rio, Asuncion

AU - Phenwan, Tharin

AU - Navarro, Mariana

AU - Ross, David

AU - Trujillo-De-Los-Santos, Zoila

AU - Yanez, Romel Jonathan Velasco

AU - Wilson, Eleanor

AU - Zuniga Santamaria, Tirso

PY - 2026/5/27

Y1 - 2026/5/27

N2 - Neurodegenerative conditions such as dementia, Parkinson's disease and motor neurone disease are progressive, life-limiting disorders associated with complex physical, psychological, social and spiritual needs over prolonged and uncertain trajectories. Palliative care is relevant throughout the course of serious illness, not only at the end of life, particularly where symptom burden, functional decline, communication challenges, decision-making needs and caregiver strain are prominent. The global burden of serious health-related suffering is increasing, while inequities in access to palliative care persist within and between countries. The World Health Organization recognises palliative care as an essential component of integrated, people-centred health services, and highlights its relevance for neurological and chronic conditions, including dementia and Parkinson's disease. However, much palliative care development has historically centred on cancer and high-income settings. Mexico is experiencing rapid population ageing alongside a growing burden of chronic and neurodegenerative conditions. An estimated 1.3 million people aged over 60 are living with dementia, with projections suggesting a marked increase by 2050. Despite policy advances, palliative care services remain uneven, fragmented and concentrated in urban or specialist settings. Existing models include transferable components such as early identification, needs-based referral, multidisciplinary coordination and advance care planning, but their effectiveness depends on context. A realist review is therefore appropriate, as it asks not only whether models work, but how, why, for whom, in what circumstances, and with what consequences. This review will generate a programme theory to inform a context-sensitive palliative care model for older adults with neurodegenerative conditions in Mexico.

AB - Neurodegenerative conditions such as dementia, Parkinson's disease and motor neurone disease are progressive, life-limiting disorders associated with complex physical, psychological, social and spiritual needs over prolonged and uncertain trajectories. Palliative care is relevant throughout the course of serious illness, not only at the end of life, particularly where symptom burden, functional decline, communication challenges, decision-making needs and caregiver strain are prominent. The global burden of serious health-related suffering is increasing, while inequities in access to palliative care persist within and between countries. The World Health Organization recognises palliative care as an essential component of integrated, people-centred health services, and highlights its relevance for neurological and chronic conditions, including dementia and Parkinson's disease. However, much palliative care development has historically centred on cancer and high-income settings. Mexico is experiencing rapid population ageing alongside a growing burden of chronic and neurodegenerative conditions. An estimated 1.3 million people aged over 60 are living with dementia, with projections suggesting a marked increase by 2050. Despite policy advances, palliative care services remain uneven, fragmented and concentrated in urban or specialist settings. Existing models include transferable components such as early identification, needs-based referral, multidisciplinary coordination and advance care planning, but their effectiveness depends on context. A realist review is therefore appropriate, as it asks not only whether models work, but how, why, for whom, in what circumstances, and with what consequences. This review will generate a programme theory to inform a context-sensitive palliative care model for older adults with neurodegenerative conditions in Mexico.

M3 - Protocol

JO - PROSPERO

JF - PROSPERO

ER -