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Older American Indians experience higher levels of cognitive impairment than previously thought, according to a recent study.

Cognitive Impairment in Older American Indians

Researchers have discovered that 54% of older American Indians have some form of cognitive impairment, with 10% of these people suffering from dementia. This figure reveals a significant health disparity compared to the general American population. The study, funded by the National Institutes of Health (NIH), was published in the journal Alzheimer's & Dementia. The research highlighted that both vascular injury and Alzheimer's disease are major contributors to cognitive impairment among American Indians.

Contributors to Cognitive Impairment

The study identifies untreated hypertension and diabetes as leading causes of vascular injury, which, along with Alzheimer's disease, significantly impacts cognitive health. The findings showed the need for targeted prevention strategies. Dr. Amy S. Kelley, deputy director of NIH's National Institute on Aging, stressed the importance of addressing health disparities to develop effective solutions for older adults.

Comparison with Other Groups

Previous research, which relied on medical records, estimated that cognitive impairment levels in American Indians were similar to non-Hispanic whites. However, the new study employed more direct methods, including surveys and personal assessments, revealing higher impairment rates. Among the 216 American Indian participants aged 72-95, 35.3% had mild cognitive impairment (MCI), 10.3% had dementia, and 8.8% had other cognitive impairments. In contrast, 45.6% showed no signs of impairment. The findings suggeted that older American Indians have higher rates of MCI and dementia compared to other groups.

Vascular Risk Factors

The research also indicated that vascular brain injury markers were more prevalent than Alzheimer's markers in cases of MCI. This suggests that both Alzheimer's disease and vascular injury are significant contributors to cognitive impairment. Dallas Anderson, PhD, MPH, an NIA program director and neuroepidemiologist, pointed out that vascular risk factors like hypertension and diabetes are modifiable and should be prioritized to reduce cognitive impairment risk among American Indians.

Study Methodology

The study was conducted by a team from the Huntington Medical Research Institutes in Pasadena, California, and the University of Washington School of Medicine in Seattle. It utilized data from the NIH-funded Strong Heart Study, a long-term population-based study of American Indian Tribes across three U.S. regions. The ancillary study included detailed cognitive testing, neurological exams, and brain imaging conducted over two visits, approximately seven years apart.

Overall, the findings underscored the urgent need for tailored interventions to address the high prevalence of cognitive impairment among older American Indians, highlighting the importance of managing vascular risk factors to improve cognitive health outcomes.