Dementias in Indian Country

What is Dementia?

• Dementia - Changes in the brain resulting in loss of cognitive function that interferes with daily life• Many Types of Dementia

• Alzheimer’s is the most common cause of dementia• Many (maybe majority) of

cases have multiple causes

Alzheimer’s Disease

Vascular Dementia

Frontotemporal Dementia

Lewy Body DementiaParkinson’s Disease Dementia Other Dementias

DEMENTIA

Scope of the Alzheimer’s Epidemic (U.S.)• 5.8 million adults• 1 in 10 adults age ≥65 • 1 in 3 adults age ≥85 • 2/3 are women• 5th leading cause of

death in US

Leading Causes of Death, US Adults 65+ Years, 2016

A Few More Facts

• 35% of people diagnosed with dementias, or their caregivers, aware of diagnosis

• About 25% of hospitalizations are preventable among older adults diagnosed with dementia

• 45% of people with Subjective Cognitive Decline discussed memory concerns with health care provider

• 70% of people with dementia live in community settings

• 95% of Medicare beneficiaries with dementia have 1 or more additional chronic conditions

• About 1 in 3 caregivers for people with Alzheimer’s report worsening health themselves

Between 2014-2060, the number of American Indians and Alaska Natives aged 65 and older living with dementia is projected to grow over five times.

Alzheimer’s is the most under-recognized threat to public health in the 21st century.

Dr. David Satcher

• Purpose• Advance cognitive health as a central part of

public health practice

• 2005: Originating Partners• Centers for Disease Control and Prevention• Alzheimer’s Association

Healthy Brain Initiative Road

Map, 2018-2023

Framework: Essential

Services of Public Health

Summary• Alzheimer’s and other dementias

affect millions of people, are costly, and are growing• Public health community must act

now to stimulate strategic changes in policy, systems, and environments• New Road Maps and data for action

will help public health and its partners chart a course for a dementia-prepared future

Healthy Brain Initiative Road Map for Indian Country• First Road Map focused on

Indian Country• Goals

• Conversation starter • Prompt local planning

• Encourage: • Public health strategies• Work across and between

generations for the good of all

Collaborative Development

Indian Health ServiceNational Indian Health BoardInternational Association for

Indigenous AgingAdministration for Community

LivingAlzheimer’s AssociationAssociation of State and

Territorial Health Officials

Centers for Disease Control and Prevention

Centers for Medicare & Medicaid Services

Healthy Brain Research Network

National Institute on AgingAnd many more . . .

• Educate and empower community members

• Collect and use data

• Strengthen the workforce

Road Map Strategies

• Educate your community about:• Brain health• Talking to a doctor about memory problems

• Increase use of programs and services that support health and wellbeing

• Help families plan for the future

• Encourage your leaders to support public health approaches to dementia

Educate & Empower Communities

Dementia and Native Communities

Getting A National Tribal Perspective . . .A Huge Public Health Challenge

• The number of older American Indians/Alaska Natives (AI/ANs) is increasing:

• Estimated 464,000 AI/ANs are older than age 65• That number is expected to

triple by 2050• Elders 85+ will increase by

8X in 2050

Elder Cohort is Increasing

Tribal Diversity

• 567 Tribes• 200 languages• Arctic Circle to Florida Everglades• One dozen to 500,000 members

Working With Tribes

“Helicopter” approaches DON’T work.

Dementia – A Community Concern

• Communities are aware and concerned of the growing problem• But …

• Few tribes have programming or resources in place to help people with dementia and their caregivers.

• Few IHS or other health programs are in place to address dementia care and awareness.

What To Do?Collaborate!

• The Tribe MUST be a significant partner at every step.

• Involve tribal leadership and staff input in initial planning and design phase and throughout work.

• Local leaders/program directors will know best/practical ways to reach their members.

What We’ve Learned

• Native communities are afraid of Alzheimer’s (dementias).

• Tribes are not yet initiating dementia programs.

• Health care providers need more education (promotes earlier diagnosis).

• Few tribal or community-based programs are in place for caregivers.

Resources for Indian Country

• Ready to use materials:• Posters• Flyers• Provider Guides• Radio PSAs• Recorded radio interview with experts• News articles

Posters

Flyer

Provider Guide

Public Service Announcements

A Healthy Heart is A Healthy Mind (30 seconds)

Older Minds Matter in Indian Country (30 seconds)

Take Action to Care for Your Heart and Mind (60 seconds)

Talk with Your Doctor About Aging and Brain Health (60 seconds)

Native Caregiver VideosIndian elders and caregivers share their experience with dementia and caregiving.

“I can’t remember:”A Native Family’s Story of Dementia

One Day at a Time: Supporting Tribal Caregivers and Elders with Dementia

Indian Country Today

News Articles on dementia signs and fears of elders and caregivers• “Steps To Take For Creating A Healthy Heart For

A Healthy Mind”• “Fear or Shame? Hiding Memory Problems As

We Get Older”

Radio Interview

Live interview on Native America Calling discussing dementia in Indian Country and support for caregivers.

Guests: Dr. Blythe WinchesterDr. J. Neil Henderson

May 7, 2019

Thanks!

For the presentation materials, contact ___________________.For information and assistance, contact Dave Baldridge at IA2:

dave@iasquared.org 505.239.4793