Cardiometabolic Conditions and All-Cause Dementia Among American Indian and Alaska Native People.

• Main Authors: Goins, R Turner, Winchester, Blythe, Jiang, Luohua, Grau, Laura, Reid, Maggie, Corrada, Maria M, Manson, Spero M, O'Connell, Joan
• Other Authors: Newman, Anne B
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: eScholarship, University of California 2022
• Subjects: Health Services and Systems; Health Sciences; Cardiovascular; Aging; Neurosciences; Prevention; Dementia; Acquired Cognitive Impairment; Clinical Research; Nutrition; Heart Disease; Brain Disorders; American Indian or Alaska Native; Arctic; Diabetes; Neurological; Good Health and Well Being; Alaskan Natives; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Hypertension; Indians; North American; Male; United States; Cardiovascular disease; Clinical Sciences; Gerontology; Biomedical and clinical sciences; Alaska
• Online Access: https://escholarship.org/uc/item/4tr4q3jd

BackgroundDiabetes, hypertension, and cardiovascular disease (CVD) are modifiable lifestyle-related cardiometabolic conditions associated with dementia. Yet, little is known regarding these associations among American Indian and Alaska Native (AI/AN) people. Thus, we examined the association of diabetes, hypertension, and CVD with all-cause dementia among AI/ANs aged 65 years and older.MethodThis was a cross-sectional analysis of the Indian Health Service Improving Health Care Delivery Data Project. Our study population was a 1:1 matched sample of 4 074 AI/ANs aged 65 years and older and Indian Health Service active users during fiscal year 2013. We employed International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes for all-cause dementia, hypertension, and CVD. Diabetes was measured with a validated algorithm to identify adults with diabetes that uses diagnoses, laboratory test results, and medication criteria.ResultsMultivariable analyses revealed that diabetes and CVD were associated with increased odds of all-cause dementia and hypertension was not. Cardiovascular disease types associated with all-cause dementia differed with cerebrovascular disease having the strongest association. Analyses stratified by gender revealed that diabetes and CVD were associated with increased odds of all-cause dementia for women and only CVD was associated with all-cause dementia for men.ConclusionsTraining and support of primary care clinicians, addressing cultural considerations, and ensuring inclusion of AI/ANs in research are steps that could help meet AI/AN people's needs. Our findings underscore to the importance of improved management and control of diabetes and CVD, which may lead to the prevention of dementia among older AI/ANs.