Researchers studying Alzheimer’s and dementia factors among Native populations

Two people sitting in chairs and smiling at one another.
Photography by TONL in partnership with Urban Indian Health Institute.

SPOKANE, Wash. — Native populations in the U.S. experience more risk factors for Alzheimer’s disease and related dementias than the general population, but are largely underrepresented in research on these conditions. Studies are also needed to further identify unique protective factors in Native communities, such as cultural and social engagement, that may significantly decrease the likelihood of these conditions. To ensure Alzheimer’s and related dementias research, including assessment of risk and protective factors, is representative of the national Native population, a group of WSU Health Sciences researchers is set to further examine these areas.

Through a newly awarded $9.6 million grant from the National Institute on Aging of the National Institutes of Health, the researchers will fund five community organizations to help study the prevalence of Alzheimer’s disease and related dementias, and their risk and protective factors, in American Indian and Alaska Native people living in urban areas. The work is being conducted out of WSU Health Sciences’ Partnerships for Native Health research program, part of its Institute for Research and Education to Advance Community Health (IREACH).

Existing research predominantly focuses on Natives living in rural or reservation settings, even though up to 80 percent of the Native population ages 65 and over live in metropolitan areas. “Urban Natives represent an ‘invisible tribe’ that is largely absent from health research,” said Dedra Buchwald, M.D., co-investigator and WSU Elson S. Floyd College of Medicine professor. “Urban environments also feature distinctive risk and protective factors. We as researchers have a responsibility to better estimate the probability of Alzheimer’s and dementias in these individuals and the impact of their environments.”

Over the next five years, the study—known as, URBAn Native Elders: Risk and Protective Factors for Alzheimer’s and Related Dementias (URBANE)—will examine an array of risk factors for Alzheimer’s disease and related dementias, including cardiovascular contributors, and how they impact disease rates among Native elders living in larger cities.

A previous WSU study found that 33 percent of Native people living on reservations showed indications of vascular brain injury, or “silent strokes”. Other risk factors found more often in Native communities included hypertension, type 2 diabetes, traumatic brain injury and family history of stroke.

“By broadening the geographic scope of this research and identifying inequities in risk factors, we can fill the knowledge gaps related to Alzheimer’s and related dementias in Native communities,” said Lonnie Nelson, PhD, principal investigator, WSU College of Nursing assistant professor, and Eastern Band of Cherokee Indians descendent. “Not only does this help reduce health disparities, we can promote prevention and treatment and improve the health of American Indians and Alaska Natives living in urban areas.”

To secure a large and geographically diverse group of urban Native participants, researchers will recruit 1,200 men and women, ages 55 and older, from several different cities with large Native populations. Recruitment will be done with the help of partners, including MedStar Health Research Institute in Phoenix, Arizona; Southcentral Foundation in Anchorage, Alaska; University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma; and University of Washington in Seattle, Washington.

The research team, led by Nelson, Buchwald and Clemma Muller, PhD, co-investigator and College of Medicine assistant research professor, will collect a variety of health-related data from all participants, including brain MRIs. This will establish a starting point for tracking cognitive health, rates of vascular brain injury and the extent to which Alzheimer’s disease and related dementias are occurring as the Native elder population continues to age.

Researchers will also look for connections to factors known to significantly increase the likelihood of experiencing Alzheimer’s and related dementias (i.e. risk factors) and those that are known to significantly decrease the likelihood (i.e. protective factors). These may include clinical, genetic, neuroimaging, behavioral, and lifestyle risk and protective factors. In estimating risk factors, researchers can consider whether interventions—such as better management of diabetes or hypertension—or certain protective factors—such as education and access to health care—can decrease disease rates.

Outcomes from the study will lay the foundation for future research on Alzheimer’s disease and related dementias among the same participants. “Greater research is needed to better inform tribes, health programs, and policy makers about the current state of Alzheimer’s disease and dementia among these individuals and about the barriers preventing many Native people from receiving proper care and diagnosis,” said Naomi Bender, PhD, director for WSU Native American Health Sciences and an indigenous Quechua woman. “Research must reflect the rich diversity of the U.S. to help ensure that each community is included in studies that lead to improved health for future generations.”

Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG064493. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Media contact: Kim Papich, WSU Health Sciences,, 509-368-6671, c 509-202-3955

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