Background and Objectives Dementia is a growing public health issue for aging Indigenous populations. Current cognitive assessments present varying degrees of cultural, educational, and language bias, impairing their application in Indigenous communities. Our goal is to provide Anishinaabe communities in Canada with a brief cognitive test that can be administered within the community setting by community health workers or professionals. The purpose of this project was to adapt the Kimberly Indigenous Cognitive Assessment (KICA) for use as a brief cognitive test with Anishinaabe populations in Canada. Research Design We used a community-based participatory research approach coupled with two-eyed seeing to provide an equitable space for Indigenous knowledge. Adaptation of the KICA was accomplished over 22 months using an iterative cycle of monthly consultations between an 11-member expert Anishinaabe language group (EALG) and the investigators, with ad hoc consultations with an Elder, a community advisory council, and the KICA authors. Face validity was established with two pilot studies using cognitive interviewing with Indigenous older adults (n=15) and a focus group consultation with local health professionals (n=7). Results Each question of the KICA was scrutinized by the EALG for cultural appropriateness, language and translation, and cultural safety. Every domain required adaptation to reflect cultural values, specificity of language, tone, and a culturally safe approach. Orientation, verbal comprehension and fluency, praxis and naming domains required the most adaptations. The first pilot for face validity resulted in additional changes; the second confirmed satisfactory adaptation of all changes. Discussion and Implications The research resulted in the new Canadian Indigenous Cognitive Assessment. The findings reveal important cultural and linguistic considerations for cross-cultural cognitive assessment in Indigenous contexts. This new culturally appropriate and safe brief cognitive test may improve case finding accuracy and lead to earlier diagnosis and improved dementia care for Indigenous peoples.

Introduction Aging Technologies for Indigenous Communities in Ontario (ATICON) explores the technology needs of Anishinaabe older adults in the Manitoulin region of Northern Ontario. Our program of research addresses inequitable access to supportive technologies that may allow Indigenous older adults to successfully age in place. Methods Using Indigenous research methodologies (IRM) and community-based participatory research (CBPR) we explored the acceptability of CareBand - a wearable location and activity monitoring device for people living with dementia using a LoRaWAN, a low-power wide-area network technology. We conducted key informant consultations and focus groups with Anishinaabe Elders, formal and informal caregivers, and health care providers (n = 29) in four geographically distinct regions. Results Overall, participants agreed that CareBand would improve caregivers’ peace of mind. Our results suggest refinement of the technology is necessary to address the challenges of the rural geography and winter weather; to reconsider aesthetics; address privacy and access; and to consider the unique characteristics of Anishinaabe culture and reserve life. Conclusion All three partners in this research, including the Indigenous communities, industry partner, and academic researchers, benefited from the use of CBPR and IRM. As CareBand is further developed, community input will be crucial for shaping a useful and valued device.

Introduction Despite increasing dementia rates, few culturally informed cognitive assessment tools exist for Indigenous populations. The Canadian Indigenous Cognitive Assessment (CICA) was adapted with First Nations on Manitoulin Island, Canada, and provides a brief, multi‐domain cognitive assessment in English and Anishinaabemowin. Methods Using community‐based participatory research (CBPR) methods, we assessed the CICA for inter‐rater and test–retest reliability in 15 individuals. We subsequently evaluated validity and established meaningful CICA cut‐off scores in 55 individuals assessed by a geriatrician. Results The CICA demonstrated strong reliability (intra‐class coefficient = 0.95 [0.85,0.98]). The area under the curve (AUC) was 0.98 (0.94, 1.00), and the ideal cut‐point to identify likely cases of dementia was a score of less than or equal to 34 with sensitivity of 100% and specificity of 85%. Discussion When used with older First Nations men and women living in First Nations communities, the CICA offers a culturally safe, reliable, and valid assessment to support dementia case‐finding.

The emergence of Alzheimer’s disease and related dementias (ADRD) in Indigenous populations across Canada is of rising concern, as prevalence rates continue to exceed those of non-Indigenous populations. The Intergenerativity Model, guided by Indigenous Ways of Knowing, nurtures a psychosocial approach to promoting healthy brain aging and quality of life. Community-based participatory action methods led by interviews, focus groups, and program observations aid in identifying the barriers to and facilitators of success for intergenerational social engagements in the Anishinaabe community of Wiikwemkoong in northwestern Ontario. A qualitative thematic analysis guides future recommendations for programming opportunities that foster traditional roles of older First Nation adults and support intergenerational relationships. The results of this project elicit culturally appropriate recommendations for community-driven supports that address healthy brain aging. These outcomes are relevant to other Indigenous communities as the framework for determining that culturally appropriate health supports can be adapted to the unique context of many communities.

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Background The Canadian Indigenous Cognitive Assessment (CICA) tool is an innovative culturally‐grounded dementia case finding tool. Currently, dementia is underdiagnosed and when diagnosis occurs it is at later stages in Indigenous populations in Canada when compared to the general population; a trend documented in Indigenous populations beyond Canada, including Australia and New Zealand. As communities and health systems prepare for rapidly aging Indigenous populations with high rates of multiple chronic conditions, the need for an accurate, reliable dementia case‐finding tool in Canada is critically needed to inform necessary supports and services. Method An interdisciplinary, international team composed of researchers and Indigenous community partners led the development of the CICA. The CICA is a community‐based adaptation of the Kimberley Indigenous Cognitive Assessment (KICA) tool, which is a validated dementia screening assessment that was originally developed with Indigenous populations in Western Australia. To adapt the KICA for Canadian contexts, we undertook iterative and community‐specific processes of translation, adaptation, and piloting before we conducted reliability and validity testing in three different sites: Manitoulin Island, Ontario, which is home to seven First Nations communities; an urban Indigenous population in Calgary, Alberta; and File Hills Qu’Appelle Tribal Council, Saskatchewan, which serves 11 First Nations communities. The adaptation process was community‐driven in each site and integrated both Indigenous community knowledge and trauma‐informed approaches to cognitive assessment. The intersections of culture, geography and colonial trauma were explored across these diverse Indigenous communities. Result The resulting CICA adaptations were scored out of a possible 39 points and took approximately 15 minutes to administer. The CICA assessed 11 domains of cognition including orientation, recognition and naming, registration, verbal comprehension, verbal fluency, recall, visual naming frontal/executive functioning, free recall, cued recall, and praxis using culturally safe methods in English, Anishinaabemowin, and Nakota. For successful adaptation from the KICA, the orientation, verbal comprehension, verbal fluency, praxis, and naming domains required the most adaptation. Preliminary results indicate that the CICA demonstrated strong inter‐rater reliability, test‐retest reliability, and criterion validity. Conclusion The CICA is the first tool of its kind in Canada and offers promising applications in the detection of dementia among Indigenous populations.

Background Traditional healing methods that prioritize the worldviews and knowledge of First Nations people and communities are pivotal and can be integrated throughout the care process in the way that dementia is screened for and diagnosed. The Canadian Indigenous Cognitive Assessment Tool is a culturally safe dementia a screening tool that requires ongoing thoughtful integration of traditional healing medicine practices to be successfully integrated into current health policy and practice across Canada. In Canada, over the next decade, the number of First Nations people over the age of 60 with dementia will increase four‐fold. This is in comparison to a 2.3‐fold increase in the non‐First Nations population. First Nations Elders seek spiritual, emotional, physical, and mental balance in preventing dementia and empowering First Nations people to live healthy lives through traditional healing medicine practices. Access to culturally safe geriatric care and dementia diagnosis among First Nations older adults is a challenge and there is little research aimed at addressing this gap. Within this limited area of research, there is even less research dedicated to how First Nations older adults’ access to traditional medicines, healing, and practices in the prevention and maintenance of dementia care. Within this forum, this presentation will highlight my learning and my passion for this research area. Through a decolonizing research approach, I propose exploring the pathways that will help to fill the gap between traditional healers and health care providers within dementia care and prevention. The primary research question is rooted in First Nations community priorities and asks: “what are the pathways to fill the gap between care providers and traditional healers to integrate traditionally healing medicine practices into dementia care and prevention in Wiikwemkoong Unceded Territory on Manitoulin Island?” Through relationship‐building and close collaboration with the First Nations community members from the Wiikwemikoong Unceded Territory, this work will exemplify how to frame and uncover the missing link between First Nations use of traditional healing medicines and First Nations dementia care within a mainstream medical system by carrying out an exploratory qualitative Indigenous research design and method.

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