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While some studies observed a significant decline in dementia prevalence between 2000 and 2012, the estimated number of people with Alzheimer’s Disease (AD) and other dementias in the United States (US) is predicted to be more than double (12.7 million) by 2050 due to demographic factors, such as population growth and aging. Despite years of focused attention, there is little information on AD and other dementias (e.g., cognitive impairment prevalence, risk factors) among American Indians (AIs). Furthermore, given the increase in life expectancy for AIs due to many positive changes in social and environmental factors, the number of AI older adults with dementia is expected to grow from 23,850 in 2010 to over 100,000 by 2050. However, only few studies have examined cognitive impairment and its risk factors among AI adults. Thus, the purpose of the current study was to investigate cognitive impairment and related risk factors among AI women in the Northern Plains.
Methods
A cross-sectional survey was conducted to collect data between October 2021 through December 2021. Purposive sampling was utilized with one rural reservation in the Northern Plains. A total of 133 AI women with a tribal enrollment identification card participated in the study. Participants were recruited from a variety of locations, including AI churches, social service centers, grocery markets, other religious organizations, senior housing facilities, and senior centers. Chi-square and t-tests were conducted to examine the differences in risk factors (i.e., age, BMI, number of chronic conditions, depressive symptoms, health literacy) between the respondents with and without cognitive impairment using an 8- item Interview to Differentiate Aging and Dementia (AD8), a brief and culturally sensitive instrument to detect early signs of dementia. The AD8 contains 8 items that test for memory, orientation, judgment, and function. AD8 has been validated for use in various settings including community, hospital, and emergency departments (Galvin et al., 2005, 2006). Logistic regression analyses investigated the risk factors associated with cognitive impairment.
Results
The mean age of the respondents was 53 years old (range 40-70). More than half of the sample had some college or more. Our results showed that approximately two-thirds of the respondents were likely to present cognitive impairment. Logistic regression analyses revealed that older respondents were more likely to present cognitive impairment. Higher levels of depressive symptomatology and numbers of chronic conditions were significant factors for cognitive impairment.
Conclusion/Implication
Our findings suggest a high risk of cognitive impairment among AI women in Northern Plains. Our results are consistent with previous research on risk factors of dementia, showing that advanced age, depressive symptomatology, and chronic conditions are associated with cognitive impairment in this sample. Future research should focus on unique risk and resilience factors associated with cognitive impairment within and between AI tribes in the Northern Plains.