Dr Kylie Radford

Senior Research Scientist and Group Leader, NeuRa & Conjoint Senior Lecturer, School of Psychology, UNSW

Title: Ageing, dementia, and longevity among Aboriginal and Torres Strait Islander peoples

Abstract:

The Aboriginal and Torres Strait Islander population of Australia is ageing rapidly and is projected to exceed half a million older people in the next 30 years. With increasing lifespan, healthy ageing is becoming synonymous with healthy brain ageing, and dementia prevention is now a national and global priority. However, Aboriginal and Torres Strait Islander peoples have higher rates of all-cause dementia, from relatively younger ages of onset, compared to non-Indigenous Australians and many other populations. Culturally safe dementia diagnosis, health and aged care pathways, and dementia literacy are thus emergent community health priorities, but so too is dementia prevention. There is accumulating evidence for potentially modifiable risk factors across the life course and targeting these could have a major impact on reducing rates of dementia. However, there is considerable diversity across populations in the nature and prevalence of dementia risk factors, currently little evidence related to early life determinants, and a need for co-design and evaluation of multi-factorial and culturally responsive risk reduction initiatives. The Koori Growing Old Well Study (KGOWS) was initiated in 2008 to determine the rates of dementia and cognitive decline in older Aboriginal and Torres Strait Islander peoples living in urban areas of eastern Australia, where much of the population reside. This study also aimed to validate several cognitive tests, examine sociocultural and biomedical risk (and protective) factors, and translate these findings into policy and practice. Working in close collaboration with five Aboriginal communities, KGOWS found higher prevalence and incidence of dementia (predominantly Alzheimer’s disease) and cognitive decline at age 60 years and older; highly consistent with findings in remote settings. A range of potentially modifiable risk factors across the lifespan were identified, alongside older age, male sex, and APOE-ɛ4, which were also significant risk factors for cognitive decline over six years. Life-course social determinants of health appear to play a substantial role in disparities in brain health and dementia for Indigenous peoples and need to be addressed in conjunction with appropriate late-life risk reduction programs, to improve healthy ageing and longevity.