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The Emergence of Dementia as a Health Concern Among First Nations Populations in Alberta, Canada

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Abstract

OBJECTIVES: Little is known about the prevalence and incidence of dementia in Aboriginal communities in Canada. As with the Canadian population, dementia in Aboriginal people is expected to be an increasing challenge for federal, provincial and community health care systems. To respond to a dearth of information concerning the prevalence of dementia in First Nations, this paper reports population-level data on dementia in the First Nations population in Alberta, Canada.

METHODS: Aggregate data obtained from Alberta Health and Wellness were analyzed. Physician-treated prevalence rates for dementia were calculated for First Nations and non-First Nations populations seeking treatment in Alberta (1998-2009). Trends in age-adjusted rates over time were compared using linear regression models. Age and sex effects were also examined.

RESULTS: In 2009, the age-standardized prevalence of dementia in First Nations in Alberta was 7.5 per 1,000 (95% CI: 6.6 to 8.5 per 1,000) compared to non-First Nations, at 5.6 per 1,000 (95% CI: 5.5 to 5.6). The prevalence of dementia rose more quickly for First Nations (p=0.032). The data suggest that dementia disproportionately affects younger age groups and males (p=0.017) in First Nations populations compared to non-First Nations.

CONCLUSIONS: Dementia represents an emerging health concern for First Nations. This increase may be driven by parallel trends, such as population aging, changing perceptions of dementia, and disproportionately higher rates of associated risk factors, impacts of the social determinants of health, and co-morbid illnesses. The unique epidemiological profile supports the need for responsive policies, programs and care geared specifically to First Nations.

Résumé

OBJECTIFS: On sait peu de choses sur la prévalence et l’incidence de la démence dans les communautés autochtones au Canada. Comme dans la population canadienne, on s’attend à ce que la démence chez les Autochtones présente un défi croissant pour les systèmes de santé fédéral, provinciaux et locaux. Pour combler le manque d’information sur la prévalence de la démence chez les Premières Nations, nous présentons des données populationnelles sur la démence dans la population des Premières Nations de l’Alberta, au Canada.

MÉTHODE: Nous avons analysé les données globales du ministère albertain de la Santé et du Bien-être. Les taux de prévalence de la démence traitée par un médecin ont été calculés pour les populations des Premières Nations et hors Premières Nations en quête de soins en Alberta (1998-2009). À l’aide de modèles de régression linéaire, nous avons comparé l’évolution dans le temps des taux ajustés selon l’âge. Nous avons aussi examiné les effets selon l’âge et le sexe.

RÉSULTATS: En 2009, la prévalence de la démence, standardisée pour l’âge, chez les Premières Nations de l’Alberta était de 7,5 p. 1 000 (IC de 95 %: 6,6 à 8,5 p. 1 000), tandis qu’hors des Premières Nations, elle était de 5,6 p. 1 000 (IC de 95 %: 5,5 à 5,6). La prévalence de la démence a augmenté plus rapidement chez les Premières Nations (p=0,032). Les données montrent que la démence touche les jeunes et les hommes de façon démesurée (p=0,017) dans les populations des Premières Nations comparativement aux populations hors Premières Nations.

CONCLUSION: La démence est un problème de santé émergent pour les Premières Nations. Son augmentation pourrait être alimentée par des tendances parallèles, comme le vieillissement de la population, l’évolution des perceptions à l’égard de la démence, ainsi que les taux démesurément plus élevés des facteurs de risque associés, les impacts des déterminants sociaux de la santé et les comorbidités. Ce profil épidémiologique singulier appelle à des politiques, des programmes et des soins plus spécifiquement adaptés aux Premières Nations.

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Author information

Authors and Affiliations

  1. Division of Human Sciences, Northern Ontario School of Medicine, Laurentian University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada

    Kristen M. Jacklin PhD

  2. School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada

    Jennifer D. Walker PhD

  3. Elder, Wikwemikong Unceded Indian Reserve, Wikwemikong, ON, Canada

    Marjory Shawande

Authors
  1. Kristen M. Jacklin PhD
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  2. Jennifer D. Walker PhD
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  3. Marjory Shawande
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Corresponding author

Correspondence to Kristen M. Jacklin PhD.

Additional information

Acknowledgements: The National Aboriginal Health Organization provided substantial guidance to the authors concerning the appropriate and effective representation of these data. We are especially grateful to Simon Brascoupe and Nicole Robinson for their detailed review of the manuscript. We also thank the Surveillance and Assessment Branch of Alberta Health and Wellness for providing the data and for their ongoing support.

Conflict of Interest: None to declare.

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Jacklin, K.M., Walker, J.D. & Shawande, M. The Emergence of Dementia as a Health Concern Among First Nations Populations in Alberta, Canada. Can J Public Health 104, e39–e44 (2013). https://doi.org/10.1007/BF03405652

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  • DOI: https://doi.org/10.1007/BF03405652

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