Title: Understanding and Addressing Alzheimers Disease within the American Indian/Alaska

Native Population of North Carolina

Authors: Elizabeth Qua Lynch, MPH (Haliwa-Saponi), University of North Carolina at
Greensboro, Greensboro, NC; Charlene Hunt, BA (Lumbee), Program Coordinator, North
Carolina American Indian Health Board, Maya Angelou Center for Health Equity, Wake Forest
Baptist Medical Center; Laura Baker, PhD, Associate Professor of Internal Medicine, Neurology
and Public Health Sciences, Wake Forest School of Medicine; Ronny Bell, PhD (Lumbee),
Professor of Public Health Sciences and Director of the Maya Angelou Center for Health Equity,
Wake Forest Baptist Medical Center, and Chair, North Carolina American Indian Health Board.
Statement of the Problem: Alzheimers disease (AD) is the sixth-leading cause of death in the
U.S., in addition to being a leading cause of morbidity and health care utilization. Data from the
North Carolina State Center for Health Statistics indicate that American Indians in North
Carolina (a state with the largest American Indian population east of the Mississippi River) are at
50% increased risk of dying from Alzheimers disease compared to non-Hispanic Whites. Type
2 diabetes is a major public health problem in American Indian populations, with prevalence
rates 2 3 times higher than the national average. Recent research has shown that type 2
diabetes is a major risk factor for Alzheimers disease and other forms of cognitive decline.
Given the high rates of type 2 diabetes in American Indian communities, it is important to
understand the relationship between these two conditions to develop culturally appropriate
prevention and treatment programs for this vulnerable population.
Research Methods: The North Carolina American Indian Health Board (NC AIHB) partnered
with the Alzheimers Research Center at the Wake Forest Baptist Medical Center in an effort to
identify the health needs and perceptions that NC-AIANs have regarding Alzheimers disease,

while simultaneously increasing awareness about the disease. The project team conducted an
extensive review of published literature and available programs and educational resources
focused on diabetes and Alzheimers disease among American Indians. The team also developed
and delivered a workshop on diabetes and Alzheimers disease at the North Carolina American
Indian Unity Conference in March 2015. Finally, the team developed a community needs
assessment questionnaire and collected data among workshop attendees and other conference
attendees.
Results: Our review of the literature indicates that there is limited research on the relationship
type 2 diabetes and Alzheimers disease among American Indians. Several programs and
educational resources are available focused individually on type 2 diabetes and Alzheimers
disease among American Indian populations, but not making the connection between the two
diseases. The Diabetes/Alzheimers disease workshop was well received and well attended, and
generated important discussions from the group on the lack of information on this topic and the
limited resources in their communities to support Alzheimers disease care. Survey data
indicated similar issues, particularly as it relates to the personal and tribal impact of these
conditions, and the lack of education/awareness opportunities within NC tribal communities.
Conclusions: Our initial efforts indicate a limited amount of research and educational resources
focused on type 2 diabetes and Alzheimers disease focused on American Indian populations.
American Indian communities in North Carolina are greatly affected by these conditions and
would greatly benefit from prevention and treatment programs.
Funding: Support for this project was provided by the North Carolina American Indian Health
Board and the Maya Angelou Center for Health Equity of Wake Forest Baptist Medical Center.