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Public Health.

Wenjun Fan1, Jiahui Dai2, Yuxi Shi1

  • 1University of California Irvine, Irvine, CA, USA.

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Summary
This summary is machine-generated.

Cognitive impairment is high in American Indian and Alaska Native adults, particularly those aged 45-60. Comorbidities like distress and diabetes are linked to cognitive decline, with some associations varying by age.

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Area of Science:

  • Neuroscience
  • Public Health
  • Gerontology

Background:

  • Cognitive impairment and comorbidity associations are unclear in American Indian and Alaska Native (AI/AN) adults.
  • This study investigated cognitive impairment prevalence and comorbidity links in AI/AN communities across age groups.

Purpose of the Study:

  • To determine the proportion of cognitive impairment in AI/AN adults aged 45+.
  • To examine the association between various comorbidities and cognitive impairment in this population.
  • To explore age-related differences in these associations.

Main Methods:

  • A 2019 cross-sectional survey of 772 AI/AN volunteers (aged 45+) in the Pacific Northwest, Rocky Mountains, and Northern Plains.
  • Data collected included demographics, Ascertain Dementia 8-item Questionnaire (AD8) responses, and self-reported comorbidities (distress, diabetes, hypertension, heart disease, stroke, head injury, alcohol use disorder, obesity).
  • Poisson regression modeled associations between AD8 scores (indicating cognitive impairment) and comorbidities, adjusting for age and sex.

Main Results:

  • Overall cognitive impairment was 35.0%, with 41.2% in the 45-60 age group.
  • All comorbidities were significantly associated with higher AD8 scores in adjusted models.
  • Distress (IRR=1.97) and diabetes (IRR=1.43) were linked to cognitive impairment in both age groups. Head injury and alcohol use disorder were associated in younger adults (<65), while stroke was associated in older adults (≥65).

Conclusions:

  • A high proportion of cognitive impairment was found in this AI/AN sample, especially in middle-aged adults.
  • Comorbidity associations with cognitive function vary by age group.
  • Recommends early cognitive screening using tools like the AD8 for middle-aged AI/AN adults, particularly those with a history of head injury or alcohol use disorder.