A scoping review and examination of conceptual frameworks of cognitive changes in Indigenous communities across...

Recent studies of cognition in Indigenous communities have documented an increased prevalence of cognitive impairment and dementia in Indigenous communities. However, Indigenous conceptualizations of both cognitive changes in aging and community health and wellness challenge methodologies and conceptual frameworks used in these studies. With Haudenosaunee Knowledge Keeper guidance, we conducted a scoping review that aims to better understand the following questions: 1. How do concepts of cognitive function and impairment differ in clinical studies and Indigenous knowledge systems? 2. How are the voices of Indigenous communities reflected in the literature in terms of both participation and leadership? We reviewed 44 relevant articles published between 2001 and 2024 on mild cognitive impairment, dementia, and other neurodegenerative diseases in Indigenous communities in Canada. We find that: 1. Inclusion of Indigenous peoples as experts in cognitive-related research produces research with outcomes relevant to and resonant with Indigenous people. 2. There are different definitions of cognitive impairment in Indigenous communities that do not align with biomedical definitions. 3. Existing cognitive assessment tools are not culturally appropriate for all Indigenous peoples and may specifically reproduce historical traumas. 4. There are significant gaps to be addressed regarding Indigenous experience of cognitive changes in aging and appropriate supports.