Cognitive impairment among community‐dwelling, off‐reserve indigenous populations in Canada

Abstract Background Limited research suggests the prevalence of cognitive impairment among Indigenous populations in Canada may be higher than that among non‐Indigenous populations. This project is focused on the understudied off‐reserve Indigenous population. We used the social determinants of health model and two‐eyed seeing approach to characterize the epidemiology of cognitive impairment in Canada’s community‐dwelling, off‐reserve Indigenous population in comparison to the non‐Indigenous population using data from the Canadian Community Health Survey (CCHS). Method A Community Advisory Board was established to provide leadership, support and direction to the research. Weights were applied to generalize estimates from the sampling population to the general population. Chi‐square tests were used to compare frequencies and prevalence estimates. Risk factors for cognitive impairment will be identified using PROC GENMOD to build a multivariate logistic regression model for Indigenous and non‐Indigenous participants. Result Weighted estimates are presented for preliminary results. The prevalence of risk factors for cognitive impairment were generally higher for the Indigenous population (e.g. smoking status, level of education, food security, marital status, rural residency, heart disease, falls, diabetes, emotional health) in comparison to the non‐Indigenous population (Tables 1 & 2; p<0.01). The Indigenous population was younger than the non‐Indigenous population with nearly half of the Indigenous population being 45‐54 years of age (49% vs 38%, p<0.01). Despite the younger age profile of the Indigenous population, the overall prevalence of mild (29% vs 25%) and severe cognitive impairment (4% vs 2%) were higher for the Indigenous population compared to the non‐Indigenous population (Table 2; p<0.01). The prevalence of dementia was <1% for both study populations (p=0.33). Given the low prevalence of dementia, our bivariate and multivariable models will focus on cognitive impairment. Age‐specific cognitive impairment prevalence estimates will be reported for each age group. Odds ratios will be reported from the final multivariable model for Indigenous and non‐Indigenous participants. Conclusion This is the first study focused on cognitive impairment among the community‐dwelling, off‐reserve Indigenous population in Canada. By characterizing the epidemiology of cognitive impairment in Indigenous populations we will increase awareness of cognitive impairment and associated risk factors in off‐reserve Indigenous populations.