Details

Autor(en) / Beteiligte

• Lavrencic, Louise
• Mack, Holly
• Withall, Adrienne
• Delbaere, Kim
• Broe, Gerald A
• Daylight, Gail
• Draper, Brian
• Lasschuit, Danielle
• Radford, Kylie

Titel

Culturally relevant protective factors and relationships with cognitive decline in First Nations Australians

Ist Teil von

• Alzheimer's & dementia, 2023-12, Vol.19 (S22), p.n/a

Erscheinungsjahr

2023

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Background First Nations people in Australia experience dementia prevalence 3‐5 times higher than the broader Australian population. There is strong focus on risk factors (particularly biomedical) in dementia research; yet further research is required to understand protective factors, especially psychosocial and cultural determinants. Cognitive reserve (CR) refers to the brain’s adaptability when faced with age or neurodegenerative‐related changes. CR is important for understanding cognitive outcomes and dementia onset. Psychosocial factors are thought to contribute to CR, including education and work opportunities. Yet, the appropriateness of conventional CR measures for First Nations people, and the role of culturally‐specific protective factors in CR, is unclear. Method Data were from the Koori Growing Old Well Study, a longitudinal, population‐based study with First Nations Australians aged 60+ from 5 rural/urban communities in New South Wales (N = 336 baseline; N = 165 6‐year follow‐up, n = 68 died before follow‐up). Comprehensive and holistic interviews were carried out. Dementia and mild cognitive impairment (MCI) were based on clinical assessment and consensus review. CR factors spanned education and work opportunities, sociocultural activities/connections, creative hobbies, playing sports, and social contact. Logistic regression analyses were used to examine factors at each life stage (early/mid/late‐life) in relation to cognitive decline (incident MCI/dementia). Result The analyses included 155 participants (excluding N = 10 with baseline dementia). Of the early‐life factors, singing (from the Retrospective Indigenous Childhood Enrichment Scale) (OR = 0.33; 95% CI 0.13, 0.86; p = .024) was associated with a lower risk of cognitive decline in the multivariable model; and years of education (OR = 0.79; 95% CI 0.66, 0.94; p = .008) predicted cognitive decline in univariable analysis. For midlife, history of unskilled work was associated with cognitive decline (OR = 5.44; 95% CI 2.32, 12.75; p = <.001). No variables in the late‐life model were significantly associated with cognitive decline. Conclusion This study is the first to examine factors that may contribute to CR in First Nations communities, including culturally‐specific items. These results suggest that certain life‐course experiences may protect against cognitive decline; however, revised and sensitive measures are needed to capture nuanced differences. A culturally relevant and more comprehensive CR measure is currently being piloted with First Nations people.