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Alzheimer's in Native American Elders

Medically Reviewed by Jennifer Robinson, MD on August 08, 2022

Alzheimer’s disease is the most common type of dementia, and it’s a fast-growing problem for everyone. Native Americans, who include American Indians and Alaska Natives, are among those expected to have a steep rise in cases. But they’ll face unique challenges.

Some of those are:

  • Trouble finding affordable and culturally sensitive health care
  • Knowledge gaps about Alzheimer’s and dementia
  • High rates of health problems linked to dementia, like diabetes
  • Added stress for caregivers

Here’s a closer look at the ways Alzheimer’s impacts older Native Americans, called Elders, and their loved ones. Plus, here are some helpful resources tailored for American Indian and Alaska Native communities.

What Does Alzheimer’s Research on Race and Ethnicity Show?

In general, Native Americans are more likely to get Alzheimer’s or other types of dementia than whites and Asian Americans are, the Alzheimer’s Association says. Also, American Indians overall have a harder time getting health care and services. They’re also less likely to get correctly diagnosed with Alzheimer’s once they show signs of it.

One study found that between the years 2000 and 2013, rates of new dementia cases were highest in Blacks, American Indians, and Alaska Natives compared to Latin people, Pacific Islanders, whites, and Asian Americans.

Researchers also found that the chances of getting dementia within 25 years of turning 65 were higher for Blacks, American Indians, and Alaska Natives compared to the other racial and ethnic groups of people.

A 2018 study looked at different racial and ethnic groups in the U.S. and compared the percentages of people 65 and older who had Alzheimer’s. Those numbers were:

  • African Americans (13.8%)
  • Hispanics (12.2%)
  • Non-Hispanic whites (10.3%)
  • American Indian and Alaska Natives (9.1%)
  • Asian and Pacific Islanders (8.4%)

What Are Some Alzheimer’s Risk Factors Among Native Americans?

Experts are still learning about what causes Alzheimer’s.

But they think certain habits and preventable health conditions may raise your chances for worse brain health and possibly dementia later in life.

The CDC says those risk factors, along with how they affect Native Americans, include:

Diabetes. American Indians and Alaska Native adults are more than twice as likely to get diagnosed with diabetes than non-Hispanic whites.

High blood pressure. American Indians and Native Americans have high rates of this compared to people from other racial and ethnic groups.

Smoking cigarettes. Out of all the racial and ethnic groups of people in the U.S., Native Americans have the highest percentage of people who smoke.

Midlife obesity. This affects more than 1 in 3 Native Americans ages 50 and older.

Traumatic brain injury (TBI). This problem can happen because of a severe blow or jolt to your head or body. American Indians and Alaska Natives have the highest rate of going to the hospital for TBIs out of all minority groups in the U.S. They also have the highest death rates from TBIs at any age.

There’s no cure for Alzheimer’s, but there are some things you can do to help lower your chances of getting it.

For example, you can practice healthy habits that are good for your overall well-being. That includes eating a balanced diet, watching your weight, and staying social.

What Obstacles Get in the Way of Diagnosis and Treatment?

A number of things can prevent many American Indians and Alaska Natives from either finding out they have Alzheimer’s or getting treatment for it. Some of these obstacles are:

Not enough awareness. About 1 in 3 Native Americans 65 and older who have memory loss have told their doctor about it, the CDC says. Memory loss that gets in the way of your daily routine may be a symptom of Alzheimer’s or another type of dementia.

Also, some Native American languages don’t have a word for “dementia.”

What’s more, over a third of Native Americans say they don’t expect to live long enough to get Alzheimer’s.

But recent stats show that American Indians and Alaska Natives are living longer, the number of Elders is growing, and your chances of getting the disease go up as you get older.

Different ideas about memory and dementia. Over half of Native Americans think that significant memory loss and brain-related declines are a normal part of getting older, the Alzheimer’s Association says.

Some believe dementia is a natural part of the transition to the next world. Others judge their memory by how well they can remember things that happened a long time ago, while Alzheimer’s usually affects your most recent memories first.

Hurdles to getting health care. American Indians and Alaska Natives who are 65 and older are more likely to have trouble getting health care than other people the same ages. That can be due to things like:

  • Lack of easy transportation to your doctor’s office or hospital
  • Needing to travel a long way to get there
  • High cost of health care and prescription drugs
  • Qualifying for, but not being enrolled in, programs like Medicaid or Medicare savings programs

Limitations of some doctors and nurses. Most Native American people feel it’s important for doctors and nurses who treat dementia to understand their ethnic and racial background and experiences.

But less than half say they’re able to see culturally competent doctors, according to the Alzheimer’s Association.

Some doctors aren’t sure which cognitive tests are best to use for Native Americans.

What’s more, many doctors and other health care workers can’t speak native languages. They also may lack awareness of tribal traditions, or struggle with speaking to Elders in a respectful and culturally sensitive way.

Also, more than half of American Indians and Alaska Natives don’t live on tribal land, so that could make it harder for them to be treated by a culturally relevant health care team.

How Common Is Caregiving in Native American Communities?

It’s not uncommon for Native Americans to take care of their Elders. For example, a survey of over 5,000 adult American Indians found that nearly 1 in 5 were caring for an older adult.

That may be linked to the fact that American Indians and Alaska Natives are more likely than people of other races and ethnicities to live in homes with more than one generation of relatives. In fact, more Native Americans ages 50 and up live in households with three or more generations, compared to other racial and ethnic groups.

What Resources Can Help?

If you’re an American Indian or an Alaska Native caregiver, or you simply want more info about ways to spread awareness about Alzheimer’s in Native American communities, you can find help through free resources like these:

Banner Alzheimer’s Institute Native American Outreach Program. This program offers community and caregiver services.

The Indigenous Cognition and Aging Awareness Research Exchange (I-CAARE). This institute offers materials aimed at First Nations and Indigenous people in Canada, but the CDC says the info can be useful for American Indians and Alaska Natives too.

The Savvy Caregiver in Indian Country Trainer’s Manual. This can help you learn about culturally sensitive caregiving techniques and get training on how to teach others in your community about caregiving.

Alzheimer’s Association TrialMatch. This matches people with dementia, caregivers, and healthy volunteers who don’t have dementia with clinical trials taking place across the U.S.

Clinical trials are research studies that test new treatments for diseases like Alzheimer’s.

Some American Indians and Alaska Natives hesitate to join clinical trials for many reasons. Those include fear of being a guinea pig and doubt that the drug being tested will have benefits.

But when enough Native Americans participate in clinical trials for Alzheimer’s and dementia treatments, it helps make sure new medical developments work well and are safe for other Native Americans.

Show Sources

SOURCES:

Alzheimer’s Association: “Native Americans and Alzheimer's,” “TrialMatch: Find Clinical Trials for Alzheimer's and Other Dementia,” “Alzheimer's Disease Facts and Figures,” “Risk Factors.”

CDC: “Road Map for Indian Country,” “10 Early Signs and Symptoms of Alzheimer's.”

Alzheimer’s & Dementia: “Inequalities in dementia incidence between six racial and ethnic groups over 14 years.”

Mayo Clinic: “Traumatic brain injury.”

Banner Alzheimer’s Institute: “Native American Outreach Program.”

Indigenous Cognition & Aging Awareness Research Exchange: “Dementia Fact Sheets.”

National Indian Council on Aging: “Orientation and Using the Manual.”

National Institute on Aging: “What Causes Alzheimer's Disease?”

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