Using Health Check Data to Understand Risks for Dementia and Cognitive Impairment Among Torres Strait Islander and Aboriginal Peoples in Northern Queensland—A Data Linkage Study

Abstract

ObjectiveHigh rates of dementia are evident in First Nations populations, and modifiable risk factors may be contributing to this increased risk. This study aimed to use a longitudinal dataset to gain insights into the long-term risk and protective factors for dementia and cognitive impairment not dementia (CIND) in a Torres Strait Islander and Aboriginal population in Far North Queensland, Australia.Study Design and SettingProbabilistic data linkage was used to combine baseline health check data obtained in 1998/2000 and 2006/2007 for 64 residents in remote communities with their results on a single dementia assessment 10–20 years later (2015–2018). The relationship between earlier measures and later CIND/dementia status was examined using generalized linear modeling with risk ratios (RRs). Due to the small sample size, bootstrapping was used to inform variable selection during multivariable modeling.ResultsOne third of participants (n = 21, 32.8%) were diagnosed with dementia (n = 6) or CIND (n = 15) at follow-up. Secondary school or further education (RR = 0.38, 95% CI 0.19–0.76, p = 0.006) and adequate levels of self-reported physical activity (RR = 0.26, 95% CI 0.13–0.52, p < 0.001) were repeatedly selected in bootstrapping and showed some evidence of protection against later CIND/dementia in final multivariate models, although these had moderate collinearity. Vascular risk measures showed inconclusive or unexpected associations with later CIND/dementia risk.ConclusionsThe preliminary findings from this small study highlighted two potential protective factors for dementia that may be present in this population. A tentative risk profile for later CIND/dementia risk is suggested, although the small sample size limits the applicability of these findings.

Dementia Risk Models in an Australian First Nations Population: Cross-Sectional Associations and Preparation for Follow-Up

“…Diabetes, for examples, was present in four of the seven models examined in this study. This risk, however, has had limited cross-sectional and longitudinal associations with dementia likelihood in First Nations Australians, including in the Torres Strait [31,[46][47][48][49], although small study samples and shorter follow-up periods may have contributed to these null results. Future research is needed to determine whether prevalent dementia risks improve the prognostic utility of dementia risk models in First Nations populations.…”

Primary care biomarkers and dementia in people of the Torres Strait, Australia: extended data analysis

“…The findings of this study may have implications for dementia reduction strategies in First Nations Australians, especially in the Torres Strait and Northern Australia. A substantial proportion of dementia in these populations may be potentially preventable (Ma'u et al, 2021 ; Thompson et al, 2022a ; Sue See et al, 2023 ). Unlike other populations, there is currently no tailored measure for quantifying future dementia risk and prompting early intervention.…”

“…This disparity likely reflects increased life-course exposure to modifiable dementia risks, which is due to upstream socioeconomic determinants (Walker et al, 2020 ). Consequently, a substantial proportion of dementia in First Nations Australians may be potentially preventable (Thompson et al, 2022a ; Sue See et al, 2023 ). Given that dyslipidaemia and chronic kidney disease (CKD) are common conditions for First Nations Australians, the indicators accompanying these conditions may provide avenues for early identification of dementia risk.…”