Dementia in Australia

Dementia has a deep impact on Aboriginal and Torres Strait Islander people (respectfully referred to as First Nations people) and communities. The following pages present the impact of dementia among First Nations people in relation to:

• Population health impacts (incidence, prevalence and deaths)
• Burden of disease
• Hospital care
• Aged care service use
• First Nations-specific health and aged care programs and caring roles.

The pages also discuss what is being done to address the impact of dementia and the availability of services to meet the needs of First Nations people.

It is essential to understand how dementia is understood and managed among First Nations people in order to devise culturally appropriate and effective policies and services. However, there are important data gaps in relation to dementia in First Nations people, which limit the robustness of analyses and the generalisability of findings for First Nations people. These gaps include the lack of First Nations representation in key survey data, and that data on available services and uptake are not necessarily available outside the organisation providing them (AIHW 2020). As such, results presented here should be interpreted carefully.

First Nations people: key demographics

The term ‘First Nations people’ refers to hundreds of different groups of people with distinct cultures, traditions and languages.

The Australian Bureau of Statistics (ABS) estimates that in 2022, there were over 896,300 First Nations people, making up 3.5% of the total Australian population. According to the ABS (2022), among First Nations people in 2021:

• 91% identified as Aboriginal people, 4.2% as Torres Strait Islander people, and 4.4% as Aboriginal and Torres Strait Islander people.
• 5.9% were aged 65 years and over, compared with 18% of non-Indigenous Australians. However, the First Nations population has been ageing and it is expected to continue to do so in the future (Temple et al. 2020).
• 37% lived in capital city areas, compared with 35% in 2016.

Perceptions of dementia and enablers for living well with dementia

Experiences of dementia and awareness of risk factors for developing dementia vary greatly among First Nations people, as with non-Indigenous Australians (Flicker and Holdsworth 2014). However, as long as dementia doesn’t affect connection to family, community, and culture, many First Nations people perceive the condition as a natural part of life and not necessarily a medical problem that needs to be fixed (Alzheimer's Australia 2006).

There are also known enablers that tend to support First Nations people with dementia, to live well. These include policies and services that: incorporate Indigenous cultural perspectives of dementia; support family and communities to care for loved ones with dementia on Country; and are controlled by the community and delivered in a culturally safe manner (see Table 12.1 for more details).

Source: Information is summarised from: Alzheimer's Australia 2006; Arkles et al. 2010; Lindeman et al. 2017; LoGiudice et al. 2020; Smith et al. 2007; Smith 2008; Smith et al. 2020; Warburton and Chambers 2007; Western Australian Centre for Health and Ageing 2010.