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Research indicates that increasing awareness of Alzheimer's Disease and Related Dementias (ADRD) can positively impact delaying the onset of symptoms. The Sociocultural Health Belief Model (SHBM) suggests that perceptions of ADRD are influenced not only by personal knowledge but also by sociocultural and environmental factors, particularly within marginalized racial/ethnic communities. Understanding the factors affecting American Indian adults' willingness to seek help for cognitive health is crucial for developing effective strategies for early diagnosis and care planning for ADRD. However, there is a significant gap in research on cognitive impairment and ADRD among Indigenous groups, including the influence of social determinants on ADRD-related help-seeking intentions. This study aims to address these gaps by assessing: 1) the levels of cognitive impairment and ADRD knowledge among Indigenous women in rural South Dakota, and utilizing the Social Determinants of Health (SDOH) framework 2) investigating the associations between selected SDOH and ADRD-related help-seeking intentions.
Methods
A cross-sectional survey was conducted among 225 American Indians (AIs) aged 18 years or older living in South Dakota in 2022. Participants were recruited from various locations including community events, ethnic newspapers/radios, post offices, and grocery stores . Cognitive impairment status was assessed using an 8-item Interview to Differentiate Aging and Dementia (AD8). Linear regression analysis was employed to investigate the associations between ADRD literacy, social engagement, attitude toward ADRD, ADRD-related stigma, health, cognitive impairment status, and health-seeking intentions.
Results
The study included respondents with a mean age of 43 (SD=16, range 18-74), among whom 45% had a high school education or less. Approximately half of the respondents reported a monthly household income of $1,900 or less. 73% reported living with family members. About 70% of the respondents were likely to have cognitive impairment. Additionally, half of the participants had sought treatment from a traditional native healer. Regression analysis revealed that individuals with higher knowledge of Alzheimer's disease and related dementia (ADRD), lower levels of ADRD-related stigma, higher levels of social engagement, and a more positive attitude toward ADRD were more likely to report an intention for help-seeking.
Conclusion/Implication
The findings underscore the importance of increasing ADRD awareness among American Indian communities. Sociocultural factors significantly influence perceptions of ADRD and help-seeking behaviors. Despite a high prevalence of cognitive impairment, there is a lack of research on ADRD among Indigenous groups, indicating a need for targeted interventions. Promoting social engagement and fostering supportive networks within Indigenous communities may encourage individuals to seek help for cognitive health issues and reduce the stigma associated with ADRD. Furthermore, further study should explore who to integrate traditional healing practices into modern healthcare approaches which may improve access to care and support for individuals with ADRD within Indigenous communities.