Abstract
Objective: Although the prevalence of dementia in remote living Aboriginal Australians is one of the highest in the world, the factors associated with dementia in this population are yet to be examined. This study was designed to determine the demographic, lifestyle and clinical factors associated with dementia in Aboriginal Australians living in the Kimberley region of Western Australia.
Method: A total of 363 Aboriginal Australians aged over 45 years from the Kimberley region were selected by semi-purposeful sampling. The factors analysed for association with dementia were age, sex, education, smoking, chewing tobacco, alcohol, head injury, heart disease, hypertension, diabetes, previous stroke, epilepsy, falls, mobility, incontinence, urinary problems, vision and hearing. This exposure data was collected from participants’ and informants’ reports using the Kimberley Indigenous Cognitive Assessment and specialist review, and medical records.
Results: Factors associated with dementia included older age, male gender (OR 3.1, 95%CI 1.4, 6.8) and no formal education (OR 2.7, 95%CI 1.1, 6.7) and after adjusting for age, sex and education, dementia was associated with current smoking (OR 4.5, 95%CI 1.1, 18.6), previous stroke (OR 17.9, 95%CI 5.9, 49.7), epilepsy (OR 33.5, 95%CI 4.8, 232.3), head injury (OR 4.0, 95%CI 1.7, 9.4), and poor mobility, incontinence and falls.
Conclusions: Interventions aimed at better management or prevention of the modifiable factors identified could reduce dementia risk in Aboriginal populations.
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Acknowledgements
Sincere thanks are extended to Kimberley Aged and Community Services, Kimberley Aboriginal Medical Services Council and the interpreters of the Kimberley Interpreting Service. Grateful assistance is acknowledged from Gordon Oscar, Edward Mungulu (named with permission from family) and Judith Brooking, Darryl Isaac, Gabriella Dolby, Brenda Green, Wayne Milgin, Kevin Nungatcha, Charlene Carrington, Laurie Churnside, Lorna Hudson, Ronald Mosquito and Melissa Sunfly who assisted with data collection, and acknowledgement of the traditional owners of Derby, Ardyaloon, Mowanjum, Looma, Junjuwa, Balgo and Warmun communities.
Declaration of interest: Research was funded through National Health and Medical Research Council grants 219194 and 353612.