Implementation Process for the Canadian Indigenous Cognitive Assessment
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Abstract
As Canada’s population ages, the number of individuals living with dementia is expected to increase.
Between April 2020 and March 2021, nearly 477,000 people above age 65 were living with diagnosed
dementia in Canada. It is thought that there were likely many more undiagnosed cases within the
population (Public Health Agency of Canada, 2024), indicating a need to better screen for and diagnose
dementia. In North America, some Indigenous populations show a higher prevalence of dementia than
non-Indigenous populations (Jacklin, Walker, and Shawande, 2013; Mayeda et al., 2016). Specifically,
dementia prevalence in First Nations people in Alberta is higher than in non-First Nations populations and
increasing more rapidly (Jacklin, Walker, and Shawande, 2013). Current widely used cognitive
assessments do not account for culture, colonization, or health and social inequalities (Jacklin et al., 2020).
This highlights the need for a culturally appropriate cognitive assessment, hence the creation of the
Canadian Indigenous Cognitive Assessment (CICA), modeled after the Kimberley Indigenous Cognitive
Assessment (KICA) from Australia (LoGiudice et al., 2006; Jacklin et al., 2020; Walker et al., 2021; Marsh
et al., 2023).
The goal of this paper is to highlight key considerations realized during the implementation process of the
CICA and what future work is required for its successful use in communities. Work was done through Dr.
Walker’s research team that is partnered with the Anishinabek Nation and Za-Geh-Do-Win Information
Clearinghouse. Results were informed by the Indigenous Dementia Research Conference on January 29 -
February 1, 2024, where many First Nations community members came together to discuss the impacts
of dementia and CICA implementation.
The results of this research can provide guidance on the opportunities and challenges when implementing
a culturally appropriate tool in First Nations communities in Ontario. This paper also highlights what future
steps and research might be needed to better support Indigenous people living with dementia and their
communities.
Description
Clara Austrins (she/her) is a White settler of European ancestry and a cisgender woman. She lives and
works on A Dish with One Spoon Treaty Territory. She is thankful for the Haudenosaunee and Anishinaabe
Peoples who traditionally live on the land she currently resides upon as an uninvited guest. Clara has been
working under the supervision of Dr. Jennifer Walker since December 2023 on projects related to
Indigenous wellbeing, biomedical research, and Indigenous data sovereignty. She is working in this field
as she finds it incredibly enlightening to learn and listen to Indigenous ways of knowing. She also finds
Indigenous ways of wellbeing to be beautifully holistic and hopes to reflect this in future aspirations
related to healthcare. Clara recognizes the daily impacts of colonization upon Indigenous Peoples and
hopes to contribute to literature reducing the deficit-based approach to Indigenous research. She is
learning from Dr. Walker to reduce the stereotyping and marginalization of Indigenous Peoples in research
that is founded in communities’ needs and results in action. She is grateful to have learned from meetings
with Dr. Jennifer Walker, Julia Rowat, Niki Naponse with Za-Geh-Do-Win Information Clearinghouse and
First Nations community members at the Indigenous Dementia Research Conference.