Strength together: Risk and protective factors for dementia and cognitive impairment in Aboriginal and Torres Strait Islander peoples

Abstract

Dementia prevalence is higher among Aboriginal and Torres Strait Islander peoples than in the non-Indigenous population, however, reported risk factors vary across studies. This study aimed to elucidate factors associated with dementia and Cognitive Impairment Not Dementia (CIND) in a harmonised dataset of Aboriginal and Torres Strait Islander participants. Univariable and multivariable logistic regression was used to assess cross-sectional factors associated with dementia and/or CIND diagnoses (N = 898). Multinomial logistic regression was applied in a longitudinal subsample (n = 354) to account for the competing risk of death when examining incident dementia/CIND. Of 898 participants, 13% had a diagnosis of dementia and 15% had CIND. Cross-sectional risk factors included age, lower educational attainment, stroke, head injury with loss of consciousness, epilepsy, no obesity and antidepressant use. Hearing impairment, urinary incontinence, mobility impairment and difficulties with certain activities of daily living were associated with a greater risk of incident dementia/CIND. This study identified several factors associated with dementia and CIND among Aboriginal and Torres Strait Islander peoples. Findings from this observational study may support clinical awareness and inform future research; however, causal relationships cannot be inferred. Further longitudinal studies are needed to clarify these associations.