Dataset Information

Cognition, Depressive Symptoms and Vascular Factors among Southwest Tribal Elders.

ABSTRACT:

Objective

Few data exist on cognitive and depressive symptoms and vascular factors in American Indian (AI) elders. Since vascular risk factors increase risk for cognitive impairments, depression and dementia, and since AI elders are at high vascular risk, it is timely to assess the interplay of these factors in comprehensive studies of aging in this population. To begin, pilot studies must be conducted to show these types of data can be collected successfully.

Design

A cross-sectional pilot study, the Southwest Heart Mind Study (SHMS).

Setting

Tribal community in the Southwest United States.

Participants

AI elders, aged ≥55 years.

Main outcome measures

Cross-cultural demographic, social network and risk factor surveys; tests of cognition, depression and anxiety; physical measurements; blood biochemistries; and APOE genotyping.

Results

SHMS elders were comparable to other rural elder populations on cognitive and depressive symptom scores. The average CogScore was 28.8 (out of 32), the average Geriatric Depression Scale (GDS) was 6.7 (of 30), and the average Hamilton Anxiety Scale was 1.2 (of 4). 32% possessed at least one APOEe4 allele. High vascular risk was evident: 76% were overweight or obese; 54% self-reported history of hypertension; 24% heart trouble; 32% type 2 diabetes; 35% depression; and 24% a family history of serious memory loss. More than 70% reported prescription medication use. 54% cared for someone besides self.

Conclusions

A better understanding of the burden of vascular risk in relation to cognition and depression among Southwest Tribes is needed.

SUBMITTER: Gachupin F

PROVIDER: S-EPMC4836905 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Publications

Cognition, Depressive Symptoms and Vascular Factors among Southwest Tribal Elders.

Gachupin Francine F Romero Michael D MD Ortega Willa J WJ Jojola Rita R Hendrie Hugh H Torres Eddie Paul Sr EP Lujan Frank F Lente Michael M Sanchez Barbara B Teller Verna V Beita Fernando F Abeita Ulysses U Lente Beatrice B Gustafson Deborah Ruth DR

Ethnicity & disease 20160421 2

<h4>Objective</h4>Few data exist on cognitive and depressive symptoms and vascular factors in American Indian (AI) elders. Since vascular risk factors increase risk for cognitive impairments, depression and dementia, and since AI elders are at high vascular risk, it is timely to assess the interplay of these factors in comprehensive studies of aging in this population. To begin, pilot studies must be conducted to show these types of data can be collected successfully.<h4>Design</h4>A cross-secti ...[more]

PMID: 27103775

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Project description:ImportanceVisual hallucinations are a core feature of dementia with Lewy bodies and primary psychiatric disease, yet identification of a hallucination vs normal spiritual experience depends on cultural context. Almost no information exists in the medical literature regarding normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation.ObjectiveTo assess the characteristics of a normal spiritual experience in an Ojibwe Tribal Nation.Design, setting, and participantsThis prospective, cross-sectional study was conducted between August 1, 2021, and August 31, 2022, among an Ojibwe Tribal Nation in northern Minnesota. Participants were evaluated at their tribal nation clinic. Cognitively unimpaired tribal Elders who were enrolled members of the tribal nation and aged 55 years or older were invited to participate via fliers, radio advertisements, and health fair presentations. Thirty-seven tribal Elders volunteered.Main outcomes and measuresEach participant was asked whether they experienced hallucinations or visions of people, animals, or objects that are not part of the physical world. This was an a priori formulated question and part of a comprehensive neurocognitive evaluation consisting of history and physical examination (including cognitive screening with a subspecialty-trained behavioral neurologist); blood tests for metabolic, nutritional, and thyroid conditions; and noncontrast magnetic resonance imaging brain scan. Four patients were excluded from the present analysis due to having mild cognitive impairment or dementia.ResultsThirty-three cognitively unimpaired tribal Elders (mean [SD] age, 66.0 [7.5] years; 22 women [67%]) were included. Sixteen (48%) answered affirmatively, reporting recurrent visions of the nonphysical world. Generally, these visions were well formed, benevolent in nature, and transient; started in preadolescence; involved spirits or ancestors; and were congruent with cultural and spiritual beliefs of the Ojibwe people. No patients had accompanying dream enactment behavior, dysautonomia, parkinsonism, sleep transition-related hallucinations, or moderate to severe depression to suggest a prodrome of an α-synucleinopathy, hypnopompic or hypnagogic hallucinations, or psychosis.Conclusions and relevanceAlthough based on only 1 Ojibwe Tribal Nation, this study suggests that formed visions of the nonphysical world are common among cognitively healthy Ojibwe individuals and can represent normal spiritual experiences. Clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric disease.

Dataset Information

Cognition, Depressive Symptoms and Vascular Factors among Southwest Tribal Elders.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Cognition, Depressive Symptoms and Vascular Factors among Southwest Tribal Elders.

Similar Datasets

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