Alzheimer's disease and related dementias and related health conditions among American Indian and Alaska Native Medicare beneficiaries

INTRODUCTION: Alzheimer's disease and related dementias (ADRD) and its associated factors are not well understood in the American Indian and Alaska Native (AI/AN) population. METHODS: We analyzed Medicare 2019 data for 112,280 AI/AN and 1,010,862 White beneficiaries aged 68+, examining the prevalence of ADRD-related health conditions and their associations with ADRD through logistic regressions. RESULTS: AI/AN beneficiaries had higher age-adjusted ADRD prevalence (15.6% vs. 13.3%), and a higher prevalence of 5 of 9 Lancet risk factors: diabetes, alcohol use disorder (AUD), tobacco use disorder, visual and hearing impairments. Traumatic brain injury (TBI), AUD, and visual and hearing impairments had stronger associations with ADRD among AI/AN beneficiaries, while depression, diabetes, and hypertension had stronger associations among White beneficiaries. DISCUSSION: Our findings highlight disparities in ADRD and related health conditions between AI/AN and White beneficiaries, potentially due to social and systematic health-care inequalities. Addressing these gaps requires culturally tailored prevention and care strategies.