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Objective: The prevalence of dementia and cognitive impairment is higher in Aboriginal Australians compared to the national population, increasing the need to understand cognitive impairment in this at‐risk population. This article reports normative data for a range of commonly used cognitive tests, in a population‐based small normative sample of older Aboriginal Australians living in urban/regional New South Wales. Method: Participants included a representative random sample of community‐dwelling older adults (60 years and older) with no cognitive impairment (n = 31), mild cognitive impairment (MCI; n = 38), or dementia diagnosis (n = 35), all from the Koori Growing Old Well Study. Cognitive tests included the Addenbrooke's Cognitive Examination Revised (ACE‐R), Digit Span (Forward and Backward), Logical Memory, and the Oral Trail Making Test (A and B). Results: Descriptive statistics and percentile scores for each test were reported for the normative sample. Comparison of performance between the diagnostic groups showed significant differences between the groups on most cognitive tests. The control group consistently performed better than the dementia group; and better than the MCI group on all tests, except for simple attention and sequencing tasks (Digit Span Forward and Oral Trail Making A). The MCI group also scored better than the dementia group on all tests, except for the Logical Memory Recognition task. Conclusion: Results support the utility of these cognitive tests that are commonly used in clinical and research settings, and demonstrate that these tests can discriminate between diagnostic groups in Aboriginal Australians. The normative data provided will enhance cognitive assessment of individuals within this population. [ABSTRACT FROM AUTHOR]

Problem: An important aspect of the work that takes place in and across our Aboriginal Health and Ageing research group is about building partnerships between Aboriginal and Torres Strait Islander peoples and non‐Indigenous people. Partnerships are created between colleagues and co‐researchers as well as with community Elders, Aboriginal community‐controlled organisations, community groups and associations and individuals. Setting: To fully realise this has required an introspective look at the way we function as a team of Aboriginal researchers and non‐Indigenous researchers working together. It has challenged us to explore and determine our shared visions and shared outcomes and to develop strong, enduring and authentic partnerships by putting culture at the centre of everything we do. Key measures for improvement: This wisdom‐led approach has fostered the development of a shared narrative about research WITH Aboriginal and Torres Strait Islander communities and a shared language of research collaboration. Strategies and effects of change: This paper aims to provide an opportunity to reflect on the key elements of co‐design which have underpinned our work together across cultures both within team and within community. Lessons learnt This paper will provide lived examples of the co‐design and co‐creation process utilised by our team in working with community. It will further share a model which underpins these experiences. It provides a framework to refer to and reflect upon, which commits to working with shared respect, shared meaning, shared knowledge and an enriched experience of collaboratively working and walking and learning together. [ABSTRACT FROM AUTHOR]

This study examined Australian primary healthcare providers' knowledge about dementia risk factors and risk reduction and their perspectives on barriers and enablers to risk reduction in practice. Primary healthcare providers were recruited through Primary Health Networks across Australia (n = 51). Participants completed an online survey that consisted of fixed-responses and free-text components to assess their knowledge, attitudes and current practices relating to dementia risk factors and risk reduction techniques. The results showed that Australian primary healthcare providers have good knowledge about the modifiable risk factors for dementia; however, face several barriers to working with patients to reduce dementia risk. Commonly reported barriers included low patient motivation and healthcare system level limitations. The most commonly reported recommendations to helping primary healthcare providers to work with patients to reduce dementia risk included increasing resources and improving dementia awareness and messaging. While the results need to be interpreted in the context of the limitations of this study, we conclude that collaborative efforts between researchers, clinicians, policy makers and the media are needed to support the uptake of risk reduction activities in primary care settings. The findings from this study showed that Australian primary healthcare providers have broadly accurate knowledge of the modifiable risk factors for dementia (when compared with the current evidence base on dementia risk reduction); but face several barriers to working with patients to reduce dementia risk. Increasing patients' awareness of dementia risk reduction and system level changes are needed to help overcome some of these barriers. [ABSTRACT FROM AUTHOR]

Dementia prevalence in Aboriginal and Torres Strait Islander Australians is three to five times higher than the general Australian population. A better understanding of the underlying biomedical and social risk factors is needed to guide dementia prevention in Aboriginal Australians. The current study is the first to examine potential risk factors for dementia in the majority urban and regional population, with a representative sample of 336 Aboriginal Australians aged 60 years and older. Participants included 45 people with a dementia diagnosis (n = 27 probable/possible Alzheimer's disease); and 286 people without dementia. Univariate logistic regression analyses (controlling for age) identified childhood trauma, mid-life factors (history of unskilled work, past high-risk alcohol use), and medical factors (history of stroke, head injury with loss of consciousness, epilepsy) as risk factors for dementia. Multivariable analysis revealed age, childhood trauma, unskilled work, stroke, and head injury as independent predictors of all-cause dementia. A range of comorbid factors related to dementia was also identified (i.e., functional impairment, incontinence, recent hospital admission, low body mass index, living in residential care, depression, current high-risk alcohol use, social isolation, low physical activity levels). These findings extend previous outcomes in a remote Aboriginal population by highlighting that life-course social determinants of health, in addition to neurological disorders, likely play an important role in elevating dementia risk. Certain psychosocial and medical exposures are highly prevalent in Aboriginal Australians, similar to other indigenous populations, and should be considered when designing targeted and culturally appropriate prevention initiatives to reduce the burden of dementia. [ABSTRACT FROM AUTHOR]

Background: Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. Methods: In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. Results: All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. Conclusion: The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]