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The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians

Published online by Cambridge University Press:  10 February 2014

Kylie Radford*
Affiliation:
Neuroscience Research Australia, Sydney, Australia Prince of Wales Hospital, Randwick, Sydney, Australia School of Medical Sciences, University of New South Wales, Sydney, Australia
Holly A. Mack
Affiliation:
Neuroscience Research Australia, Sydney, Australia
Hamish Robertson
Affiliation:
Prince of Wales Hospital, Randwick, Sydney, Australia
Brian Draper
Affiliation:
Neuroscience Research Australia, Sydney, Australia Prince of Wales Hospital, Randwick, Sydney, Australia School of Psychiatry, University of New South Wales, Sydney, Australia
Simon Chalkley
Affiliation:
Neuroscience Research Australia, Sydney, Australia Prince of Wales Hospital, Randwick, Sydney, Australia Geriatric Medicine, University of New South Wales, Sydney, Australia
Gail Daylight
Affiliation:
South Eastern Sydney Local Health District, Sydney, Australia
Robert Cumming
Affiliation:
Neuroscience Research Australia, Sydney, Australia School of Public Health, University of Sydney, Sydney, Australia
Hayley Bennett
Affiliation:
Neuroscience Research Australia, Sydney, Australia
Lisa Jackson Pulver
Affiliation:
Neuroscience Research Australia, Sydney, Australia Muru Marri Indigenous Health Unit, University of New South Wales, Sydney, Australia
Gerald A. Broe
Affiliation:
Neuroscience Research Australia, Sydney, Australia Prince of Wales Hospital, Randwick, Sydney, Australia Geriatric Medicine, University of New South Wales, Sydney, Australia
*
Correspondence should be addressed to: Dr Kylie Radford, Neuroscience Research Australia, PO Box 1165, Randwick, NSW 2031, Australia. Phone: +02-9399-1269; Fax: +02-9399-1082. Email: k.radford@neura.edu.au.

Abstract

Background:

Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians.

Methods:

We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. “normal” range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of “gold standard” clinical consensus determinations of cognitive impairment and dementia.

Conclusion:

This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

Type
Protocol-Only Paper
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Akhtar, A. J., Broe, G. A., Crombie, A., McLean, W. M., Andrews, G. R. and Caird, F. I. (1973). Disability and dependence in the elderly at home. Age and Ageing, 2, 102111.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
Anstey, K. and Sargent-Cox, K. (2009). Growing healthy brains from birth and keeping them healthy during adulthood: a life-course approach to cognitive epidemiology and dementia. Australasian Epidemiologist, 16, 1113.Google Scholar
Arkles, R., Jackson Pulver, L., Robertson, H., Draper, B., Chalkley, S. and Broe, G. (2010). Ageing, Cognition and Dementia in Australian Aboriginal and Torres Strait Islander Peoples. Sydney: Neuroscience Research Australia and Muru Marri Indigenous Health Unit, UNSW.Google Scholar
Australian Bureau of Statistics (2010). Population Characteristics, Aboriginal and Torres Strait Islander Australians (Report No. 4713.0, reissue). Canberra: Australian Bureau of Statistics.Google Scholar
Barnes, D. E. and Yaffe, K. (2011). The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurology, 10, 819828.Google Scholar
Broe, G. A. (2003). Population ageing, human lifespan and neurodegenerative disorders: a fifth epidemiologic transition. In Sachdev, P. S. (ed.), The Ageing Brain (pp. 1131). Lisse, The Netherlands: Swets & Zeitlinger.Google Scholar
Burgess, C. P. et al. (2009). Healthy country, healthy people: the relationship between Indigenous health status and “caring for country”. Medical Journal of Australia, 190, 567572.Google Scholar
Folstein, M., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Garvey, G. et al. (2011). Making sense of dementia: understanding amongst Indigenous Australians. International Journal of Geriatric Psychiatry, 26, 649656.Google Scholar
Hendrie, H. C. et al. (1993). Alzheimer's disease is rare in Cree. International Psychogeriatrics, 5, 514.Google Scholar
Hill, K., Barker, B. and Vos, T. (2007). Excess Indigenous mortality: are Indigenous Australians more severely disadvantaged than other Indigenous populations? International Journal of Epidemiology, 36, 580589.Google Scholar
Kalton, G. and Anderson, D. W. (1986). Sampling rare populations. Journal of the Royal Statistical Society, Series A: Statistics in Society, 149, 6582.Google Scholar
Llibre Rodriguez, J. J. et al. (2008). Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey. Lancet, 372, 464474.CrossRefGoogle Scholar
LoGiudice, D. et al. (2006). Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians. International Psychogeriatrics, 18, 269280.Google Scholar
McKeith, I. G. et al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 65, 18631872.Google Scholar
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's and Dementia, 7, 263269.Google Scholar
Moceri, V. M. et al. (2001). Using census data and birth certificates to reconstruct the early-life socioeconomic environment and the relation to the development of Alzheimer's disease. Epidemiology, 12, 383389.CrossRefGoogle Scholar
Neary, D. et al. (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 15461554.CrossRefGoogle ScholarPubMed
Pollitt, P. A. (1997). The problem of dementia in Australian Aboriginal and Torres Strait Islander communities: an overview. International Journal of Geriatric Psychiatry, 12, 155163.Google Scholar
Radford, K. and Mack, H. (2012). Dementia Screening for Urban Aboriginal Australians: The Modified Kimberly Indigenous Cognitive Assessment (mKICA). Sydney: Dementia Collaborative Research Centres.Google Scholar
Smith, K. et al. (2008). High prevalence of dementia and cognitive impairment in Indigenous Australians. Neurology, 71, 14701473.Google Scholar
Smith, K. et al. (2010). Factors associated with dementia in Aboriginal Australians. Australian and New Zealand Journal of Psychiatry, 44, 888893.Google Scholar
Storey, J. E., Rowland, J. T., Basic, D., Conforti, D. A. and Dickson, H. G. (2004). The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. International Psychogeriatrics, 16, 1331.CrossRefGoogle Scholar
Thomas, D. P. et al. (2006). Long-term trends in Indigenous deaths from chronic diseases in the Northern Territory: a foot on the brake, a foot on the accelerator. Medical Journal of Australia, 185, 145149.CrossRefGoogle Scholar
Thornton, M. and Travis, S. (2003). Analyisis of the reliability of the modfied caregiver strain index. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 58B, 127132.CrossRefGoogle Scholar
Vos, T., Barker, B., Begg, S., Stanley, L. and Lopez, A. D. (2009). Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. International Journal of Epidemiology, 38, 470477.Google Scholar
Waite, L. M., Broe, G. A., Grayson, D. A. and Creasey, H. (2001). The incidence of dementia in an Australian community population: the Sydney Older Persons Study. International Journal of Geriatric Psychiatry, 16, 680689.Google Scholar
Winblad, B. et al. (2004). Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240246.CrossRefGoogle Scholar
Zann, S. (1994). Identification of Support, Education and Training Needs of Rural/Remote Health Care Service Providers Involved in Dementia Care. RHSET Project Progress Report. Queensland: Northern Regional Health Authority.Google Scholar
Supplementary material: PDF

Radford Supplementary Material

Table S1

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Supplementary material: PDF

Radford Supplementary Material

Table S2

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