R01AG074231

Addressing Alzheimer's Disease and Related Dementias Disparities: The American Indigenous Cognitive Assessment (AMICA) Project tackles the significant dementia disparity that exists for Indigenous populations by determining the scalability of recently developed, culturally tailored, brief cognitive tests for dementia for use in diverse American Indian (AI) populations.

Compared to the majority population, Indigenous rates of Alzheimer's Disease and Related Dementias (ADRD) are approximately 3 times higher. This research will adapt and validate a battery of complementary Indigenous cognitive assessment tools developed in Canada and Australia for use among AI populations in the United States. This battery expands and adapts the Canadian Indigenous Cognitive Assessment (CICA), as well as the Australian Kimberley Indigenous Assessments for Depression (KICA Depression), Activities of Daily Living (KICA-ADL), and a Caregiver Report (KICA-Carer).

Culture and context are central to Indigenous peoples' experience with dementia and dementia diagnosis. Due to significant cultural differences between tribal populations in Australia, Canada, and the US, existing Indigenous culturally valid clinical tools cannot be used in the US until they are first adapted and re-validated. Until unbiased tools are developed, we run the risk of basing critical clinical and policy decisions on flawed epidemiological estimates of ADRD which, in turn, further exacerbates dementia inequities.

Using community-based participatory research approaches blended with Indigenous methodologies, we will revise existing Indigenous assessments to align with AI cultural context as well as the neuropsychiatric properties. We intend to measure and assess the reliability, validity, and cultural acceptance of the adapted instruments with a total of 390 dyads of people with dementia and their caregivers (N=780) in two culturally distinct tribal communities in Minnesota, Wisconsin, and an urban AI population in New Mexico.

Our central hypothesis is that developing a culturally safe cognitive assessment approach that accounts for cultural context will provide accurate diagnoses, which in turn will help us achieve our long-term goal of improving the diagnosis and care of Indigenous persons with dementia across the ADRD continuum. Our specific aims are to:
1) Create American Indian appropriate versions of the CICA COG, KICA Carer, KICA Depression, and KICA-ADL (the "AMICA Battery").
2) Assess the psychometric properties and cultural acceptability of the four tools in the AMICA Battery. We hypothesize that the AMICA Battery will demonstrate strong reliability, validity, sensitivity, specificity, positive and negative predictive value relative to the Two-Eyed Seeing Consensus Diagnosis. Thus, the AMICA Battery will produce the same diagnoses, while providing greater cultural safety, than the standard assessments.

By achieving these aims, we can expect to deliver the first culturally adapted valid cognitive assessment battery for American Indian older adults. In doing so, this research will help to reduce disparities, accelerate research, and enhance access to high-quality clinical practice.

Regents Of The University Of Minnesota

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Duluth, Minnesota 558052804 United States

Single Zip Code

Research on Current Topics in Alzheimer's Disease and Its Related Dementias (R01 Clinical Trial Optional) (PAR-19-070)

Amendment Since initial award the total obligations have increased 343% from $1,800,689 to $7,983,648.