This page presents the latest data showing the population health impacts of dementia among Indigenous Australians including:
Prevalence and incidence of dementia
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:
- Rates of dementia for Indigenous Australians in remote and rural communities are among the highest in the world. For Indigenous Australians aged 45 and over living in the remote Kimberley region of Western Australia, dementia prevalence was 12.4% (Smith et al. 2008), and when followed up 7 years later for those aged 60 and over, dementia incidence was 21 per 1,000 person years (LoGiudice et al. 2016).
- Across the Northern Territory, the age-adjusted prevalence of dementia diagnoses recorded in electronic health data systems for Indigenous Australians aged 45 and over was 6.5%, compared with 2.6% among the non-Indigenous Australians (Li et al. 2014).
- Indigenous Australians also had a younger age of onset of dementia, with a median age of 72 years compared with a median age of 79 years among non-Indigenous Australians. The age-adjusted incidence rate of dementia among Indigenous Australians aged 45 and over was about 2.5 times as high as the rate among non-Indigenous Australians (27 and 11 per 1,000 person years, respectively) (Li et al. 2014).
- Among urban and regional dwelling Indigenous Australians aged 60 and over, the prevalence of dementia was about 3 times higher than the overall Australian prevalence for the same age group (21% and 6.8%, respectively), with Alzheimer’s disease being the most common type of dementia present. Dementia prevalence rates among urban and regional dwelling Indigenous Australians were slightly lower compared to rates among Indigenous Australians living in remote areas (Radford et al. 2017).
- A study by Russell et al. (2020), estimated a dementia prevalence of 14.2% among Torres Strait Islanders aged between 45 and 93 years.
- The ARC Centre for Excellence in Population Ageing Research projected that by 2051, the relative growth in the number of Indigenous Australians aged 50 years and over with dementia will be 4.5 to 5.5 times the 2016 estimated prevalence (Temple et al. 2022). The study attributes this to the Aboriginal and Torres Strait Islander population ageing, where age is a known risk factor for dementia.
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 and Holdsworth 2014; Goldberg et al. 2018; Radford et al. 2019). 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 (AIHW 2020; Griffiths et al. 2019). 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 2016–2020; 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.