First Nations Australians with dementia

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

First Nations people: key demographics

The term ‘First Nations people’ refers to the first peoples of Australia. They are not one group, but hundreds of different groups of people with distinct cultural traditions languages and histories.

The Australian Bureau of Statistics (ABS) estimates that as at 30 June 2021, there were 984,000 Aboriginal and Torres Strait Islander people, making up 3.8% of the total Australian population (ABS 2023). The Aboriginal and Torres Strait Islander population is younger than the non-Indigenous population, with both larger proportions of young people and smaller proportions of older people. For example, among First Nations people in 2021, 5.4% were aged 65 years and over, compared with 17% of non-Indigenous Australians. However, the First Nations population has been ageing as people are living longer and it is expected to continue to do so in the future (Temple et al. 2020).

Perceptions of dementia and enablers for living well with dementia

Cultural factors – like connection to and caring for country, cultural expression, self-determination, knowledge and beliefs and family and kinship – are important to First Nations people and tend to positively impact their health and wellbeing (AIHW 2024c).

However, 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). As long as dementia doesn’t affect connection to family, community and culture, some 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).

The causes of Aboriginal dementia in Gugu Yimithurr culture is part of a natural process. The body, mind and spirit naturally get older including the brain... It may not need to get fixed as long as the individual is safe and the family and the community is safe there may not be any need to do anything at all.

Mr. Eric Deeral

Chairperson, Elders Justice Group, Hopevale Community, Queensland

Policies and services can enable First Nations people with dementia to live well when they:

  • incorporate First Nations cultural perspectives of dementia
  • support family and communities to care for loved ones with dementia on Country
  • are controlled by the community and delivered in a culturally safe manner (see Table 12.1 for more details).
Table 12.1: Common enablers among First Nations people for living well with dementia
Cultural security
  • Availability of culturally safe health and aged care services
  • Availability of Aboriginal and Torres Strait Islander community-controlled health and aged care services, especially community-controlled aged care
  • Growing the First Nations workforce in all areas of aged care
  • Appropriate transport options to access preferred services
  • Use of culturally appropriate and co-designed screening tools for dementia and quality of life, and creating culturally safe care plans
Caring for family and friends with dementia
  • Availability of culturally safe and community-controlled aged care support services, so families and communities can care for people with dementia on Country
  • Integrated care models with well-coordinated health and aged care service provision
Ongoing culture
  • Many First Nations people view dementia as a natural part of the life cycle rather than an illness, as long as the person with dementia (including their family and community) are safe and that it doesn’t affect their connection to family, community and culture.

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.

Barriers to accessing health care for First Nations people living with dementia

First Nations people frequently experience significantly poorer health outcomes than non-Indigenous Australians, largely due to the historic and ongoing effects of colonisation and racism (AIHW 2024c). One specific driver of this difference in health outcomes is the lack of health care access and use by First Nations people (Looper and Gaétan 2009). Barriers to accessing health services for First Nations people, generally, include services not being available in their area (especially for those living in remote areas), services being too far away, lack of transport, cost, waiting times, and the availability of culturally safe and responsive health services (AIHW 2024d).

Stolen Generations survivors are more likely to develop dementia because of the trauma they experienced (Radford et al. 2017). First Nations people living with dementia may experience higher barriers to access, especially when it comes to receiving timely dementia diagnosis. Contributing factors include:

  • denial and stigma associated with dementia
  • limited community awareness and understanding of dementia
  • perception of dementia as a low priority health condition
  • fear of having to leave Country (for example, relocation to a metropolitan or regional centre to receive treatment or residential care)
  • lack of culturally appropriate services
  • complex and competing issues facing individuals and communities (Bryant et al. 2021).

See First Nations People and the Health System for more information.

Need more information?

If you require more information about dementia among First Nations people, or if you are an Aboriginal and/or Torres Strait Islander person and want to know where to seek help if dementia is suspected or want to find out about available support services, refer to:

Dementia Australia (for resources for First Nations communities)

National Dementia Helpline: 1800 100 500 (a free and confidential service available 24/7 to discuss dementia and memory loss concerns for yourself or others)

Dementia Support Australia (free resources for First Nations communities, including communication cards and a First Nations language guide)

Dementia Behaviour Management Advisory Service: 1800 699 799 (free and confidential support available 24/7 throughout Australia, including in rural and remote locations, to help Aboriginal and Torres Strait Islander people and their carers to manage behaviour associated with dementia)

My Aged Care (for information on supporting First Nations people accessing aged care).

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