Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians

Kylie Radford, Louise M. Lavrencic, Kim Delbaere, Brian Draper, Robert Cumming, Gail Daylight, Holly A. Mack, Simon Chalkley, Hayley Bennett, Gail Garvey, Thi Yen Hill, Danielle Lasschuit, Gerald A. Broe

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Dementia prevalence in Aboriginal and Torres Strait Islander Australians is three to five times higher than the general Australian population. A better understanding of the underlying biomedical and social risk factors is needed to guide dementia prevention in Aboriginal Australians. The current study is the first to examine potential risk factors for dementia in the majority urban and regional population, with a representative sample of 336 Aboriginal Australians aged 60 years and older. Participants included 45 people with a dementia diagnosis (n = 27 probable/possible Alzheimer's disease); and 286 people without dementia. Univariate logistic regression analyses (controlling for age) identified childhood trauma, mid-life factors (history of unskilled work, past high-risk alcohol use), and medical factors (history of stroke, head injury with loss of consciousness, epilepsy) as risk factors for dementia. Multivariable analysis revealed age, childhood trauma, unskilled work, stroke, and head injury as independent predictors of all-cause dementia. A range of comorbid factors related to dementia was also identified (i.e., functional impairment, incontinence, recent hospital admission, low body mass index, living in residential care, depression, current high-risk alcohol use, social isolation, low physical activity levels). These findings extend previous outcomes in a remote Aboriginal population by highlighting that life-course social determinants of health, in addition to neurological disorders, likely play an important role in elevating dementia risk. Certain psychosocial and medical exposures are highly prevalent in Aboriginal Australians, similar to other indigenous populations, and should be considered when designing targeted and culturally appropriate prevention initiatives to reduce the burden of dementia.

    Original languageEnglish
    Pages (from-to)S75-S85
    Number of pages11
    JournalJournal of Alzheimer's Disease
    Volume70
    Issue numbers1
    DOIs
    Publication statusPublished - 13 Aug 2019

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    Dementia
    Craniocerebral Trauma
    Stroke
    Alcohols
    Social Determinants of Health
    Social Isolation
    Urban Population
    Unconsciousness
    Wounds and Injuries
    Nervous System Diseases
    Population Groups
    Population
    Epilepsy
    Alzheimer Disease
    Body Mass Index
    Logistic Models
    Regression Analysis
    Exercise
    Depression

    Cite this

    Radford, K., Lavrencic, L. M., Delbaere, K., Draper, B., Cumming, R., Daylight, G., ... Broe, G. A. (2019). Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians. Journal of Alzheimer's Disease, 70(s1), S75-S85. https://doi.org/10.3233/JAD-180573
    Radford, Kylie ; Lavrencic, Louise M. ; Delbaere, Kim ; Draper, Brian ; Cumming, Robert ; Daylight, Gail ; Mack, Holly A. ; Chalkley, Simon ; Bennett, Hayley ; Garvey, Gail ; Hill, Thi Yen ; Lasschuit, Danielle ; Broe, Gerald A. / Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians. In: Journal of Alzheimer's Disease. 2019 ; Vol. 70, No. s1. pp. S75-S85.
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    abstract = "Dementia prevalence in Aboriginal and Torres Strait Islander Australians is three to five times higher than the general Australian population. A better understanding of the underlying biomedical and social risk factors is needed to guide dementia prevention in Aboriginal Australians. The current study is the first to examine potential risk factors for dementia in the majority urban and regional population, with a representative sample of 336 Aboriginal Australians aged 60 years and older. Participants included 45 people with a dementia diagnosis (n = 27 probable/possible Alzheimer's disease); and 286 people without dementia. Univariate logistic regression analyses (controlling for age) identified childhood trauma, mid-life factors (history of unskilled work, past high-risk alcohol use), and medical factors (history of stroke, head injury with loss of consciousness, epilepsy) as risk factors for dementia. Multivariable analysis revealed age, childhood trauma, unskilled work, stroke, and head injury as independent predictors of all-cause dementia. A range of comorbid factors related to dementia was also identified (i.e., functional impairment, incontinence, recent hospital admission, low body mass index, living in residential care, depression, current high-risk alcohol use, social isolation, low physical activity levels). These findings extend previous outcomes in a remote Aboriginal population by highlighting that life-course social determinants of health, in addition to neurological disorders, likely play an important role in elevating dementia risk. Certain psychosocial and medical exposures are highly prevalent in Aboriginal Australians, similar to other indigenous populations, and should be considered when designing targeted and culturally appropriate prevention initiatives to reduce the burden of dementia.",
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    Radford, K, Lavrencic, LM, Delbaere, K, Draper, B, Cumming, R, Daylight, G, Mack, HA, Chalkley, S, Bennett, H, Garvey, G, Hill, TY, Lasschuit, D & Broe, GA 2019, 'Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians', Journal of Alzheimer's Disease, vol. 70, no. s1, pp. S75-S85. https://doi.org/10.3233/JAD-180573

    Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians. / Radford, Kylie; Lavrencic, Louise M.; Delbaere, Kim; Draper, Brian; Cumming, Robert; Daylight, Gail; Mack, Holly A.; Chalkley, Simon; Bennett, Hayley; Garvey, Gail; Hill, Thi Yen; Lasschuit, Danielle; Broe, Gerald A.

    In: Journal of Alzheimer's Disease, Vol. 70, No. s1, 13.08.2019, p. S75-S85.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Delbaere, Kim

    AU - Draper, Brian

    AU - Cumming, Robert

    AU - Daylight, Gail

    AU - Mack, Holly A.

    AU - Chalkley, Simon

    AU - Bennett, Hayley

    AU - Garvey, Gail

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    Radford K, Lavrencic LM, Delbaere K, Draper B, Cumming R, Daylight G et al. Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians. Journal of Alzheimer's Disease. 2019 Aug 13;70(s1):S75-S85. https://doi.org/10.3233/JAD-180573