Native Americans and Alzheimer's

One in 5 Native American adults aged 45 and older reports experiencing memory or thinking problems that might be a sign of dementia. Learn what the Alzheimer's Association is doing to address health disparities and provide support for American Indians living with Alzheimer's or other dementias.  


 

Quick facts

Native Americans are more likely to develop Alzheimer's or other forms of dementia than White or Asian Americans. At the same time, American Indians overall have less access to healthcare and health services and are less likely to be diagnosed once they show symptoms, creating unique challenges in addressing Alzheimer's and other dementias. In addition, Native American cultures hold great esteem for Elders and are more likely to take care of their Elders at home. This may create stress for caregivers.
 

• As many as 1 in 3 Native American Elders will develop Alzheimer's or some other form of dementia.
• Between 2020 and 2060, the number of American Indian/Alaska Native individuals aged 65 and older living with dementia is projected to increase four-fold.
• The vast majority (92%) of Native Americans say that it is important for Alzheimer’s and dementia care providers to understand their ethnic or racial background and experiences. However, only 49% of Native Americans say that they have access to culturally competent providers.
• 61% of Native Americans say that affordability of care is a barrier.
• More than one-fourth (27%) of Native American caregivers report being treated with less respect than others.
• Four in 10 (40%) of Native Americans believe that medical research is biased against people of color and only 65% believe that an Alzheimer's cure will be shared fairly, regardless of race, color or ethnicity.

For more information, please see the Association's Alzheimer's Disease Facts and Figures special report on Race, Ethnicity and Alzheimer's in America (PDF). 

Native Americans at risk
The report Memory Loss and Alzheimer's Disease in Native People tells the stories of Native American Elders living with Alzheimer's and their caregivers and reiterates the importance of early detection.

Because American Indians had considerably shorter lifespans than White Americans during the 19th and 20th centuries, Alzheimer's and other dementias were relatively rare. People aged 65 and older now comprise 15% of the overall Native American population, compared to 4.8% in the 1970s. Some Native American languages don't even have a word for "dementia." But now, as Native American lifespans are more likely to reach the prime ages for the development of Alzheimer's and other dementias, awareness of Alzheimer's and its symptoms is lower compared to other populations.

There are knowledge gaps, especially about caregiving and disease risk, among Native Americans. There are also different perceptions of memory and dementia. Some perceive dementia as a normal part of aging or accompanying the transition to the next world. Others gauge memory by the ability to recollect the distant past, while Alzheimer's typically first affects the most recent memories.

Valerie Jones, a member of the Navajo Nation, describes her work first with the Navajo Department of Health and now with the Indian Health Service on education, data collection, and caregiver support for Alzheimer's and dementia. She emphasizes the need for culturally appropriate education and support and ensuring that the community owns and takes pride in local resources.
 

Conversations Around Equity and Dementia

Perceptions of Alzheimer's and dementia

• About two-thirds (65%) of Native Americans say that they know somebody with Alzheimer’s.
• Only 25% of Native Americans say that they are worried about developing Alzheimer's disease.
• More than one-third of Native Americans (35%) say that they do not expect to live long enough to develop Alzheimer's.
• More than half (53%) of Native Americans believe that significant memory or cognitive losses are a normal part of aging.

 

Association partnerships

The Alzheimer's Association partners with several organizations to better serve all communities in the United States, including the National Indian Council on Aging (NICOA), to promote Alzheimer’s awareness and care and support resources to American Indian individuals from 574 tribes across the country.

The Indian Health Service (IHS), an agency within the Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized tribes in 37 states. Its goal is to raise the health status of American Indians and Alaska Natives to the highest possible level. The Alzheimer's Association and the IHS will work together to address and improve the health and well-being of American Indians and Alaska Natives living with Alzheimer's disease and all other dementias and their caregivers.

In 2019, the Alzheimer's Association and the CDC collaborated on the The Healthy Brain Initiative (HBI) Road Map for Indian Country, the first-ever public health guide focused on dementia in Native American communities. Success stories highlight how tribes can utilize the Road Map to improve health outcomes. The International Association for Indigenous Aging (IASquared) is a partner of the HBI and serves as a hub of information and resources on Alzheimer's and other dementia serving Indian country.

At the Alzheimer's Association, we believe that diverse perspectives are critical to achieving health equity — meaning that all communities have a fair and just opportunity for early diagnosis and access to risk reduction and quality care. The Association is committed to engaging underrepresented and underserved communities and responding with resources and education to address the disproportionate impact of Alzheimer’s and dementia.
 

Perceptions of clinical trials

The most common reasons that Native Americans cite for not being interested in participating in clinical trials are fear of being a guinea pig (51%), doubt that there would be any benefits (36%), the belief that the time and cost might be too much (31%) and not trusting pharmaceutical companies (26%). They are considerably less than other groups to believe that treatment might make them sick, with 18% of Native Americans citing this as a concern.

A collaboration with the Oneida Nation of Wisconsin greatly increased clinical trial participation among members of the tribe. The researchers found that they needed to prioritize building relationships and active collaborations with the community as a foundation for engaging members in clinical trials.
 

Participate in the Alzheimer’s Association TrialMatch®

These findings suggest there is a lot of work ahead to achieve better health equity. The solution includes engaging, recruiting and retaining diverse populations in Alzheimer’s research and clinical trials. Why is this important? Just like risk factors for a particular health condition are affected by genetics and ancestry, the effectiveness and safety of treatments can vary by factors such as age, gender, weight, other health conditions, and ethnicity.

To make sure that new medical developments in Alzheimer's and dementia are effective and safe for American Indians, medical trials need to recruit enough American Indians to participate in clinical research. Alzheimer’s Association TrialMatch is a free, easy-to-use clinical studies matching service for people living with dementia, caregivers and healthy volunteers without dementia. The TrialMatch database lists hundreds of Alzheimer’s research studies taking place at sites across the country and online. Search for relevant studies and connect with research teams with the click of a button.

Don’t just hope for a cure — help us find one. Learn more about clinical trials.
 

Make a difference: Volunteer with the Alzheimer's Association

Millions of Americans are impacted by Alzheimer’s disease, but you can do something to help by becoming an Alzheimer’s Association volunteer. Our ability to reach and support those affected depends on people like you who are dedicated to the fight against this disease.

As an Association volunteer, you can use your unique talents to make a meaningful impact in your community while connecting with others who share your passion. Read how Valerie Tsosie, Navajo, a community educator with the New Mexico chapter, works as a community educator to support Diné caregivers. Barbara Tinhorn, member of the Hualapai Tribe, has actively engaged her community in Alzheimer's education, and started a bimonthly support group on the reservation. 

Volunteer opportunities are available in care and support, research, advocacy and fundraising events. Getting started is easy — sign up today at alz.org/volunteer.

Resources

• For people living with Alzheimer's.
• Infographic for sharing (PDF).
• For caregivers.
• Brain health.
• Free 24/7 helpline.
• International Association for Indigenous Aging: 10 Signs of Thinking or Memory Changes That Might Be Dementia (PDF).