Australian Institute of Health and Welfare (2022) Dementia in Australia, AIHW, Australian Government, accessed 03 February 2023.
Australian Institute of Health and Welfare. (2022). Dementia in Australia. Retrieved from https://www.aihw.gov.au/reports/dementia/dementia-in-aus
Dementia in Australia. Australian Institute of Health and Welfare, 16 September 2022, https://www.aihw.gov.au/reports/dementia/dementia-in-aus
Australian Institute of Health and Welfare. Dementia in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2023 Feb. 3]. Available from: https://www.aihw.gov.au/reports/dementia/dementia-in-aus
Australian Institute of Health and Welfare (AIHW) 2022, Dementia in Australia, viewed 3 February 2023, https://www.aihw.gov.au/reports/dementia/dementia-in-aus
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This page presents the latest data showing the population health impacts of dementia among Indigenous Australians including:
Although there are no national-level estimates of the number of Indigenous Australians with dementia, studies examining different communities of Indigenous Australians have consistently found that dementia prevalence rates are about 3–5 times as high as rates for Australia overall.
High dementia prevalence (that is, all dementia cases in a given period) and incidence (that is, new dementia cases in a given period) have been documented recently for very different groups of Indigenous Australians:
Evidence of high prevalence, younger onset, and high incidence of dementia, suggests that without interventions to help moderate the impact of dementia, its burden among Indigenous Australians will continue to grow in coming years.
Preventing dementia in Indigenous Australians requires an understanding of the underlying medical and social risk factors for developing dementia. Some important risk factors that present at higher levels among Indigenous Australians include: head injury, stroke, diabetes, high blood pressure, renal disease, cardiovascular disease, obesity, hearing loss, childhood stress and trauma, and lower socioeconomic status (Flicker & Holdsworth 2014; Radford et al. 2019; Goldberg et al. 2018). A key national research priority is to develop and evaluate culturally responsive programs, interventions and policies to reduce dementia risk factors across the life course and prevent or delay the onset of cognitive decline and dementia (including by targeting social determinants of health) (NHMRC 2020).
Continuing the improvement and quality of Indigenous identifiers in administrative data sets would support better dementia prevalence estimates for Indigenous Australians across Australia (Griffiths et al. 2019; AIHW 2020). Similarly, ensuring the availability and uptake of culturally sensitive and validated assessment tools to diagnose cognitive decline and dementia would lead to improved estimates of dementia prevalence as well as better diagnosis of dementia among Indigenous Australians. The Kimberley Indigenous Cognitive Assessment (KICA) tool is an example of such a tool, which allows for the cognitive screening of older Indigenous Australians living in urban, rural (KICA urban regional) and remote (KICA remote) areas of Australia, as well as the assessment of possible dementia. The complete resource package includes patient and carer assessments, family reports, pictures, and an instruction booklet and video. These are available from Aboriginal Ageing Well Research.
This section reports on deaths where dementia was recorded as the underlying cause of death, and refers to these as deaths due to dementia. It also presents death statistics aggregated over several years as a result of the small number of deaths due to dementia among Indigenous Australians in any given year. Refer to Deaths due to dementia for more information on dementia-related deaths for all Australians. See the Technical notes for more information about deaths data, such as known issues with under-identification of Indigenous Australians.
During 2018–20, 318 Indigenous Australians died due to dementia (202 women and 116 men). During this period, dementia was the fifth leading cause of death among Indigenous Australians aged 65 and over (298 deaths, after coronary heart disease, chronic obstructive pulmonary disease, diabetes, and lung cancer), accounting for 11% of all deaths among Indigenous Australians aged 65 and over.
To assess trends in deaths due to dementia over the past 10 years, the number of deaths due to dementia for 2011–2015 were compared to the number of deaths in the most recent 5-year period (2016–20). The number of deaths due to dementia among Indigenous Australians increased in the most recent 5-year period (2016–20) for men and women across all ages (Figure 12.1). During 2011–2015, there were 296 deaths due to dementia among Indigenous Australians, while there were 503 deaths due to dementia during 2016–20; this is equivalent to a 70% increase in deaths due to dementia among Indigenous Australians during this period.
Between 2016 and 2020, most deaths due to dementia among Indigenous men and women occurred among those aged 85 and over, but a larger proportion of Indigenous men (71%) were aged less than 85 compared to Indigenous women (52%). With an ageing Indigenous Australian population, it is expected that the number of deaths due to dementia will continue to rise in the future.
Figure 12.1 is a bar graph showing the number of deaths due to dementia among Indigenous Australians during 2011–2015 and 2016–2020 by age and sex. Indigenous Australians aged 85 or older accounted for the largest number of deaths due to dementia for both time periods, but the number of deaths in 2016–20 were greater than in 2011–2015.
The majority of deaths among Indigenous Australians due to dementia in 2018–20, were recorded as due to Unspecified dementia (215 or 68% of deaths due to dementia), followed by Alzheimer’s disease (19%) and Vascular dementia (10%) (Table S12.4). These dementia types were also the most common types recorded overall among Australians who died due to dementia in 2020 (see the Deaths due to dementia).
A nationwide study of mortality data between 2006–2014 showed that deaths with dementia were 57% higher among Indigenous Australians compared to non-Indigenous Australians, with the biggest difference occurring among men and those aged less than 75 years. Indigenous Australians were also more likely to have dementia coded as Unspecified dementia, compared to non-Indigenous Australians (Waller et al. 2021).
Due to the low number of deaths among Indigenous Australians for particular types of dementia, and because there are known limitations with the accuracy and consistency of dementia coding on death certificates, the breakdowns by dementia subtypes presented here can only be considered indicative of the distribution of dementia types among Indigenous Australians. For more information on these limitations, see Deaths due to dementia and Technical notes.
After accounting for population differences in different geographic areas in Australia, there are notable geographic variations in deaths due to dementia during 2018–20 (Figure 12.2). Age-standardised rates of deaths due to dementia among Indigenous Australians were:
Figure 12.2 is a bar graph showing the age standardised rate of deaths due to dementia among Indigenous Australians during 2018–20 by state or territory and remoteness areas. The highest rate was in the Northern Territory with 115 deaths due to dementia per 100,000 Indigenous Australians and lowest in New South Wales (42 deaths per 100,000 Indigenous Australians). Remote and very remote areas had the highest rate of deaths due to dementia among Indigenous Australians (117 deaths per 100,000 Indigenous Australians) and the lowest rate was in Inner and outer regional areas (49 deaths per 100,000 Indigenous Australians).
The discussion about dementia deaths among Indigenous Australians has so far been restricted to deaths due to dementia, that is, where dementia was recorded as the underlying cause of death. In addition to the underlying cause of death, the National Mortality Database contains information on up to 19 associated causes of death—that is, other causes that were instrumental or significantly contributed to the death. Given people with dementia often have other health conditions and there can only be 1 underlying cause of death recorded, it is important to also account for all other cases where Indigenous Australians died with dementia (where dementia was recorded as either the underlying cause or an associated cause of death).
During 2018-20, around half of all deaths with dementia among Indigenous Australians were deaths due to dementia (318 deaths out of 646). This proportion increased by age at death, from 41% of deaths with dementia among Indigenous Australians who died aged under 75, to 53% among Indigenous Australians who died aged 85 or over. Across all age groups, the number of deaths involving dementia were much higher when associated cause of death information on dementia was included.
Figure 12.3 is a bar graph showing deaths due to dementia and deaths with dementia among Indigenous Australians during 2018–20 by age. Just over one quarter of all the deaths of Indigenous Australians with dementia were accounted for by those aged less than 75 years during 2018–20. The number of deaths with dementia increased with age to 247 among those aged 85 years or older (or 38% of all deaths of Indigenous Australians with dementia). Overall, deaths due to dementia accounted for about half of the deaths with dementia of Indigenous Australians during this period.
When dementia was an associated cause of death, common underlying causes of death included: diabetes, coronary heart disease and cerebrovascular disease (Table S12.7). These conditions were also common underlying causes of death among Australians generally when dementia was an associated cause of death (Table S3.6).
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Goldberg LR, Cox T, Hoang H & Baldock D (2018) 'Addressing dementia with Indigenous peoples: a contributing initiative from the Circular Head Aboriginal community'. Australian and New Zealand Journal of Public Health 42(5):424–426. doi:10.1111/1753-6405.12798
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NHMRC (National Health and Medical Research Council) (2020) Aboriginal and Torres Strait Islander roadmap for dementia research and translation, NHMRC, Australian Government, accessed 17 August 2022.
Radford K, Delbaere K, Draper B, Mack HA, Daylight G, Cumming R et al. (2017) 'Childhood stress and adversity is associated with late-life dementia in Aboriginal Australians'. The American Journal of Geriatric Psychiatry 25(10):1097–1106, doi:10.1016/j.jagp.2017.05.008.
Radford K, Lavrencic LM, Delbaere K, Draper B, Cumming R, Daylight G et al. (2019) 'Factors associated with the high prevalence of dementia in older Aboriginal Australians'. Journal of Alzheimer's Disease 70(s1):S75–S85, doi:10.3233/JAD-180573.
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Waller M, Buckley RF, Masters CL, Nona FR, Eades SJ & Dobson AJ (2021) 'Deaths with dementia in Indigenous and Non-Indigenous Australians: a nationwide study'. Journal of Alzheimer's Disease 81(4):1589–1599, doi:10.3233/JAD-201175.
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