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

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing Pub Date : 2025-03-05 DOI:10.1111/ajag.70007

Kate Bradley, Jo-anne Hughson, Zoë 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

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引用次数: 0

Abstract

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.

Abstract Image

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土著人和托雷斯海峡岛民的认知障碍、痴呆和相关危险因素的检测：一项阶梯形聚类随机对照试验的回顾性基线审计结果

目的土著人和托雷斯海峡岛民患痴呆症、认知障碍（CIND）及相关危险因素的比例较高。本文的目的是概述在土著社区控制的卫生组织（ACCHOs）就诊的患者中记录在案的痴呆、CIND和相关风险因素的基线审计结果。方法在昆士兰州、新南威尔士州、维多利亚州和西澳大利亚州的城市、地区和偏远地区的12个ACCHOs参与了研究。专门的审计工具确定了记录在案的CIND、痴呆和风险因素。完成了2016年9月1日至2019年1月31日期间1655名50岁及以上客户的病历审计。结果患者平均年龄60.3±8.2岁，女性占57%。记录在案的CIND或痴呆的总体患病率很低，只有67例（4%）患者。危险因素的流行率很高，超过三分之二（71%,n = 1168）的队列具有与痴呆和CIND相关的≥4个危险因素。其中包括高血压（56%）、糖尿病（45%）、血脂异常（48%）、肥胖（40%）和当前吸烟（42%）的高发率。结论：在这个初级卫生保健机构中，CIND和痴呆的检出率很低，同时相关危险因素的患病率很高。这些发现强调了在不同地理环境下改善土著和托雷斯海峡岛民患者群体的痴呆和CIND检测的必要性。研究结果还提供了对风险因素患病率的见解，为管理策略提供信息。需要在文化上适当并与ACCHOs共同设计的认知护理响应模式来满足这一需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.