Detection of cognitive impairment, dementia and associated risk factors among Aboriginal and Torres Strait Islander peoples: Retrospective baseline audit results from a stepped-wedge cluster-randomised controlled trial.
Kate Bradley, Jo-Anne Hughson, Zo�� Hyde, David Atkinson, Sarah Russell, Rachel Quigley, Dawn Bessarab, Leon Flicker, Kylie Radford, Kate Smith, Edward Strivens, Sandra Thompson, Irene Blackberry, Mary Belfrage, Robyn Smith, Roslyn Malay, Belinda Ducker, Kylie Sullivan, Wendy Allan, Bonnie Giles, Tina Humphry, Louise M Lavrencic, Dimity Pond, Dina LoGiudice
Author Information
Kate Bradley: The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Jo-Anne Hughson: The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Zo�� Hyde: Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia. ORCID
David Atkinson: Rural Clinical School of Western Australia, The University of Western Australia, Broome, Western Australia, Australia.
Sarah Russell: College of Medicine & Dentistry, James Cook University, Cairns, Queensland, Australia. ORCID
Rachel Quigley: College of Medicine & Dentistry, James Cook University, Cairns, Queensland, Australia. ORCID
Dawn Bessarab: Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australia, Perth, Western Australia, Australia.
Leon Flicker: Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia. ORCID
Kylie Radford: Neuroscience Research Australia, Sydney, New South Wales, Australia. ORCID
Kate Smith: Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australia, Perth, Western Australia, Australia. ORCID
Edward Strivens: College of Medicine & Dentistry, James Cook University, Cairns, Queensland, Australia.
Sandra Thompson: Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia, Australia.
Irene Blackberry: John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, Victoria, Australia.
Mary Belfrage: The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Robyn Smith: The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Roslyn Malay: Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia.
Belinda Ducker: Neuroscience Research Australia, Sydney, New South Wales, Australia.
Kylie Sullivan: Neuroscience Research Australia, Sydney, New South Wales, Australia.
Wendy Allan: Neuroscience Research Australia, Sydney, New South Wales, Australia.
Bonnie Giles: John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, Victoria, Australia.
Tina Humphry: Derbarl Yerrigan Health Service, Perth, Western Australia, Australia.
Louise M Lavrencic: Neuroscience Research Australia, Sydney, New South Wales, Australia.
Dimity Pond: Berowra Family Medical Practice, Sydney, New South Wales, Australia.
Dina LoGiudice: The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Royal Melbourne Hospital, Melbourne, Victoria, Australia. ORCID
OBJECTIVE: Aboriginal and Torres Strait Islander peoples experience high rates of dementia, cognitive impairment not dementia (CIND) and associated risk factors. The objective of this paper is to outline baseline audit results of documented dementia, CIND and associated risk factors in patients attending Aboriginal Community-Controlled Health Organisations (ACCHOs). METHODS: Twelve ACCHOs in urban, regional and remote locations across Queensland, New South Wales, Victoria and Western Australia participated in the study. A specialised audit tool identified documented CIND, dementia and risk factors. Medical record audits of 1655 clients aged 50���years or older for the period from 1 September 2016 to 31 January 2019 were completed. RESULTS: The mean age of patients was 60.3��������8.2���years, and 57% were female. The overall prevalence of documented CIND or dementia was low, noted for only 67 (4%) patients. The prevalence of risk factors was high, with over two thirds (71%, n���=���1168) of the cohort having ���4 risk factors associated with dementia and CIND. These included high rates of hypertension (56%), diabetes (45%), dyslipidaemia (48%), obesity (40%) and current smoking (42%). CONCLUSIONS: There was a low detection of CIND and dementia accompanied by a high prevalence of associated risk factors in this primary health-care setting. These findings highlight the need to improve dementia and CIND detection in Aboriginal and Torres Strait Islander patient groups across varied geographical settings. The findings also provide insights into risk factor prevalence to inform management strategies. Responsive models of cognitive care that are culturally appropriate and co-designed with ACCHOs are required to address this need.
