Using Health Check Data to Understand Risks for Dementia and Cognitive Impairment Among Torres Strait Islander and Aboriginal Peoples in Northern Queensland-A Data Linkage Study

Objective: High rates of dementia are evident in First Nations populations, and modifiable risk factors may be contributing to this increased risk. This study aimed to use a longitudinal dataset to gain insights into the long-term risk and protective factors for dementia and cognitive impairment not dementia (CIND) in a Torres Strait Islander and Aboriginal population in Far North Queensland, Australia.

Study Design And Setting: Probabilistic data linkage was used to combine baseline health check data obtained in 1998/2000 and 2006/2007 for 64 residents in remote communities with their results on a single dementia assessment 10-20 years later (2015-2018). The relationship between earlier measures and later CIND/dementia status was examined using generalized linear modeling with risk ratios (RRs). Due to the small sample size, bootstrapping was used to inform variable selection during multivariable modeling.

Results: One third of participants ( = 21, 32.8%) were diagnosed with dementia ( = 6) or CIND ( = 15) at follow-up. Secondary school or further education (RR = 0.38, 95% CI 0.19-0.76, = 0.006) and adequate levels of self-reported physical activity (RR = 0.26, 95% CI 0.13-0.52, < 0.001) were repeatedly selected in bootstrapping and showed some evidence of protection against later CIND/dementia in final multivariate models, although these had moderate collinearity. Vascular risk measures showed inconclusive or unexpected associations with later CIND/dementia risk.

Conclusions: The preliminary findings from this small study highlighted two potential protective factors for dementia that may be present in this population. A tentative risk profile for later CIND/dementia risk is suggested, although the small sample size limits the applicability of these findings.