Dementia prevalence in Indigenous Australians
One of our recent studies has shown that dementia prevalence in Indigenous Australians, aged over 60, is three times higher than the overall Australian population.
What is it that helps one person age successfully and cause another to develop age-related diseases like dementia? Scientifically, we know too little about normal ageing and what factors influence some people and not others to develop diseases that affect the brain. Only by studying healthy elderly people, as well as those with problems, can we know what normal ageing looks like. We can also learn what activities, lifestyles and other factors are important for staying healthy as we age.
With the focus on our Aboriginal Australians, our original Koori Growing Old Well Study (KGOWS) involved a population census, comprehensive structured interview of potential risk and protective factors across the lifespan, and detailed geriatrician assessment plus case review by a panel of specialist clinicians – geriatricians and neuropsychologists – to diagnose dementia.
Our rigorous approach allowed us to accurately assess the prevalence of dementia, not just those ‘in the system’ already seeking treatment/care, and identify specific types of dementia.
Advancing age is the number one risk factor, but a concerning finding is that dementia onset for many in our study was at relatively young ages i.e. before age 65. The prevalence of previous stroke and head injury are also relatively high in older Aboriginal populations and also related to dementia, but this is certainly not the only reason. Early childhood adversity, reduced access to education and stimulating work opportunities, stress, and other social determinants of health are also likely to be contributing to the higher burden of dementia for Aboriginal Australians.
Our Aboriginal health and ageing team, with our collaborators, is now conducting a follow-up Koori Growing Old Well Study to confirm risk and protective factors, extend this research into more diverse Indigenous communities across Australia, and to develop and evaluate appropriate prevention strategies across the lifespan. This study explores healthy ageing and cognition in urban Aboriginal communities in New South Wales, in particular looking at how life events affect healthy ageing Australian population. Almost nothing is known about the incidence of dementia in urban Aboriginal communities
We have also initiated the Koori Active and Healthy Ageing Project, which identifies causes of decline, promotes vitality and supports communities. Specifically, the project examines how to implement evidence-based healthy brain ageing (dementia prevention) programs in urban and regional Aboriginal communities.
It looks at dementia causes, prevention and care in Indigenous Australians, but will also be transferable to mainstream questions about the inter-relationships between head injury, stroke or vascular brain pathology, and amyloid deposition with Alzheimer’s and vascular dementias – the common types of dementia found in all populations worldwide. Dementia is a growing concern and burden on communities for Aboriginal Australians.
This research will develop effective, culturally appropriate, and accessible strategies to promote healthy ageing and prevent dementia in Aboriginal communities. It will also investigate better ways to assess memory and thinking in this population, in order to identify changes as early as possible for enhanced dementia research and treatment prospects.
The Koori Dementia Care Project (KDCP) is also underway. It aims to inform, educate and build capacity in urban and regional NSW Aboriginal communities, and with associated service providers, about the effects of dementia on older Aboriginal people and their families. KDCP is funded by Ageing Disability and Home Care and supported by Neuroscience Research Australia and the Dementia Collaborative Research Centre.
The primary aims of KDCP are:
- Increased dementia awareness and knowledge across the communities of La Perouse, Campbelltown, The Far North Coast and Mt Druitt.
- Increased acceptance of appropriate community services for those living with dementia and their families.
- Translation of the knowledge gained in KGOWS into capacity building for Aboriginal and non-Aboriginal service providers and health workers.
- Development and dissemination of information and communication strategies to urban and regional Aboriginal communities on the topic of dementia.
- Improvement and timely diagnosis of dementia, increased take-up of support for carers through increased community and family education, increased understanding and acceptance of the range of community support services available for carers and development of a person-centred, or community centred, model of care within Aboriginal care.
Projects under Ageing and dementia in Aboriginal Australians: promoting vitality, identifying decline and supporting communities are led by Prof Tony Broe AM, Dr Kim Delbaere and Dr Kylie Radford.