![[ Visit Client Website ]](images/banner.gif)
The US Indigenous population aged 65 and above was 301,418 in 2019, and it is expected to increase to 648,555 by 2060. The number of Indigenous people aged 65 and above with memory loss is projected to grow over five times between 2014-2060. Indigenous older adults face significant challenges in obtaining timely Alzheimer's disease and related dementias (ADRD) diagnosis and services. The rate of cognitive impairment in Indigenous people under 65 is higher than that of non-Indigenous people worldwide, but little research has been done to understand cognitive impairment and AD among Indigenous groups. Social determinants of health (SDOH) are crucial factors in cognition and AD risk, which are potentially modifiable at the systemic, community, and individual levels. Indigenous people have experienced health and social inequities, leading to chronic health conditions and an increased risk of developing AD. This study investigated the levels of cognitive impairment and ADRD knowledge among Indigenous women in rural South Dakota, using the SDOH framework to investigate the associations between selected SDOH and cognitive impairment status.
Methods
A cross-sectional survey collected data from a rural reservation in the Northern Plains between October and December 2021. 123 AI women with a tribal enrollment identification card participated in the study, recruited from various locations. Chi-square and t-tests compared risk factors between the normal cognition group and the cognitive impairment group, using an 8-item Interview to Differentiate Aging and Dementia (AD8). The study provided the percentages of correct responses to Alzheimer’s disease knowledge (ADK) items for the total sample and sub-samples with cognitive impairment. Logistic regression analyses were conducted to examine the associations between ADRD literacy, social context, health, and cognitive impairment status.
In this study, respondents (N= 123) had a mean age of 53 (range 40-70), and over half had some college education. Two-thirds were likely to have cognitive impairment. The normal cognition group had higher knowledge of Alzheimer's disease and related dementia (ADRD) than the cognitive impairment group. Age and depressive symptoms were associated with cognitive impairment. Higher levels of knowledge in Treatment and Management and Life Impact were associated with lower odds of cognitive impairment, with 40% and 60% lower odds, respectively, using a cut-off score of 2.
Conclusion/Implication
Our study revealed moderate Alzheimer's disease knowledge among American Indian participants, with an average score of 18.4 and 61% correct responses. These results are consistent with Jerigan et al.'s (2020) study of American Indian/Native Alaskan pow-wow attendees in the Pacific Northwest. The findings emphasize the need for tailored interventions such as screening and education. Furthermore, our study contributes to understanding the impact of social determinants on cognitive impairment among Indigenous populations and can guide future efforts to promote health equity in these communities. The findings emphasize the need for tailored interventions such as screening and education. Furthermore, our study contributes to understanding the impact of social determinants on cognitive impairment among Indigenous populations and can guide future efforts to promote health equity in these communities.