Prevalence And Incidence Of Dementia In Urban And Regional Aboriginal Australians
The Aboriginal community incorporates about more than 3% of the Australian population and knows how noticeably health imbalance with compared to remain Australian community (ABS, 2013). Regional Aboriginal health deficiency is seen in every field of health likewise mental health, inability and life expectancy. In Aboriginal community’s differences in life expectancy, the rate of disease in early age and level of negative biological and social risk factors causing dementia in regional Aboriginal population. Dementia is typically defined as a clinical syndrome of cognitive decline that is sufficiently severe to interfere with social or occupational functioning. Diagnosis also involves a detailed medical and neurological examination, and a formal mental status examination including bedside cognitive testing (H. Chertkow, 2011). Dementia has been studied all of the different groups of ethnic, but no similar result was found in regional Aboriginal people. Thus, the scientists identified the prevalence of dementia. In this research of remote-living Aboriginal Australians, the researchers aimed to determine the prevalence and incidence of dementia and describe the mortality. The researchers' emphases that the prevalence of incidence of dementia is higher among Indigenous populations. The researchers stated that dementia was highly present at a younger age group and old age group. A cross-sectional study design was used to study dementia in Aboriginal male and female aged between 60 years and above Aboriginal living in an urban and regional area. The study was involved in two different phases with 336 participants. Phase one participants finished structure interview related to life history. But only 153 participant’s case reviewed by consensus panel for diagnosis.
The researchers made a questionnaire to count dementia index. Dementia diagnosed by counting the activity of daily living. The outcome of both phase was the dementia index and compared with each other to determine dementia onwards the sample size. Similarly, stability incidence and prevalence were compared with each other by data which are collected from phases study. The data was determined using a cross-sectional study. The study found that a census of Regional areas Aboriginals men and women Aged group of 60 years and above in the 546 participants among the target communities, with 336 in the cross-sectional study Whereas 153 participants also completed their whole medical assessment. Although, the prevalence of dementia was not changed and the rate of mortality was higher among the Aboriginals who are at baseline. Crude prevalence of dementia was around 13. 4% and the age standardizes rate was 21. 0%. Among the most of the cases with Alzheimer's dementia around 44% and all different types of dementia mixed together diagnoses approximately 29%. The final estimated prevalence was 17. 7 in mild cognitive impairment regarding the standard criteria. The study concluded regional or urban area Aboriginals Australians populations more facing dementia compared with general population. Dementia is linked to a higher rate of mortality. The prevalence and incidence of this health issues were also higher compared to dementia. This could state that programs target dementia and aging- regarding support are required greater than the social program.
General
The title of the research paper is reflecting the aim of the study and the population being studied and it also has a better study design. The periods when study design conducted it also included in the title which will represent more information in the title. The research paper also contains with logical construction and it's easy for a reader because the flow of writing is excellent. In addition to that writer also mentions everything in sequence like title followed by abstract and then a method of design and end of the description with a conclusion. The Author also used the proper study design and put a study report with participants. The paper is written in clear and easily understandable styles by using a language flow in each and every paragraphs. The author used statistical data to show the previous report or to show them when the study conducted by using a cross-sectional study design. The research paper also used the relevant data from the different research paper to make it very easy and clear just as an example, remote areas indigenous people had higher rates of illiteracy, lack of education and a problem with speak in English as a second language (L. Flicker, 2008).
The research paper has no any type of grammatical or typing mistakes. It also writes in good manners with no spelling mistakes inside. The flow of paper is easily understood by the reader due to using simple academic language. Abstract and keywordsMeanwhile, the research paper contains concise or comprehensive which give all information regarding the article and make a balance by a summary. The abstract has all elements which are most important for epidemiological study and provided it in a good manner. A reader of the article could easily understand how it happened and what are the logical result of the study by reading the abstract of the article. It was a good idea to mention the keyword inside the paper likewise “Indigenous population”, “Alzheimer's disease”, “Mild cognitive impairment”, “Vascular dementia" which provide hints to the reader on what this article it represents. Keywords such as disability and mortality could be included with the principle variables which are counted in the research.
Introduction, Aims, and Objectives
The introduction is appropriate to the subject of the paper. One of the most important strengths of the research is the introduction part. The beginning of the paragraph gave a clear idea of the remote areas or urban areas Aboriginal population and differences in life expectancy, level of biological and social factors. The introduction part also used the link which is connected with the scientific research and provides information of risk of health and their lifestyle which makes them the higher risk of dementia compared with the general people. Firstly, the literature which is used in the introduction relevant and comprehensive. Secondly, the part of introduction also seems original in concept. The researcher mentioned the different point of view of other research paper by putting a view of the different author such as the prevalence of dementia was same in Indigenous Cree sample and a non-Indigenous sample of Canadian and the ratio of Alzheimer's-type of dementia were lower in the group of indigenous( H. C. Hendrie, 1993). Therefore the aim of the study followed logical manners from the literature and clearly mentioned and it also has a null hypothesis stated. MethodsThe design of the study consistent with aims by using a cross-sectional population-based survey with the help of different five local Aboriginal controlled community health organizations which are two in Sydney metropolitan area followed by three on the mid-north coast of New South Wales in Australia.
In addition to that largest Aboriginal populations in NSW compared to other states of Australia. The research paper contains the appropriate method and it is applicable for a prevalence of dementia in regional or urban areas Indigenous people. Meanwhile, the pilot study sites performed to test the methodology based on local government area boundaries, to along with Australian Bureau of Statistics population census reporting. The sites which are chosen here is generally representative of the urban or regional Aboriginal population distribution. A census study performed to identify all regional and urban areas residents aged between 60 years or more than 6o years in these communities using Snowball technique. So the sample of the research paper also represents the question of population. There is no need for controls in the study of an article. In a research paper, another significant aspect is the high response rate which was reported by local Aboriginal health and community service which are very sensitive based on cultural. The method of selecting the sample, cases, and controls clearly described with using a snowballing technique with community members, support of local organizations, and local Aboriginal researcher's employed study. This technique recommended in Aboriginal populations with not available identity and where people are known each other (G. Kalton, 1986).
Moreover, the other details likewise numbers, statistical tests and time periods which are clearly described in the research paper. For an example, dementia screening tests which are the phase1 with Mini-Mental State Examination (K. Radford, 2014) other one is modified Kimberley Indigenous Cognitive Assessment (H. Robertson, 2014) and Rowland Universal Dementia Assessment Scale (J. E. Storey, 2004). In addition to that modified Kimberley Indigenous Cognitive Assessment scale was adapted for regional setting of validate assessment of cognition in Aboriginal people. (D. Logiudice, 2006) and is scored is total 39 participants. Participants who are under the maximum score which are tested in phase 2. Phase 2 included a 90 minute medical and cognitive check-up with a physician who is an expert in dementia. The examiners or enumerators have been trained and calibrated because they are using every statistical test which is relevant to the study. Data were counted by using IBM SPSS Statistics software and Microsoft Excel 2010. The pro forma and questionnaires have been used and it’s tested.
These questionnaires are relevant to the study and they presented with a different phase study table in the article. This paper also includes a clear statement with ethical approval. The clear explanation was stated in the article. Phase 2 medical assessment was reviewed by clinicians including one geriatrician and the one clinical neuropsychology. ist. All-cause dementia due to persisting of substance abuse because of medical conditions and cognitive impairment (B. Winblad, 2004). This research paper is applicable and has potential consent. The study was approved by the Aboriginal Health and Medical Research Council, the University of New South Wales Human Research Ethics Committee and NSW Population & Health Services Research Ethics Committee and Cancer Institute NSW. The author mentioned the whole information regarding the participants to make it more easy for a reader. The research paper also states the age 60 years and more than 60 years old Aboriginal residing in the site of study for 6 months. Exclusion criteria with current incarceration and stroke in the last 3 months. A writer also mentioned the sample size details for readers. In this research paper, the sample size of Aboriginal no of 336 people aged between 60 years or more than that counted by 60% rate of participants among the total population and a 95% probability the sample estimated between 19. 65 and 28. 4%. This prevalence rate of dementia found in remote communities. Whereas in phase 2, the data was reviewed by three different clinicians and determine the dementia type by standard diagnostic criteria.
Results
The results and statistical tests presented in a clear and unambiguous manner such as the study show that 546 participants across the different five study sites which compared well with their references number of 609 or regional Aboriginal people, based on their total available population's statistics during the study. Of those aged between 60 to 92 years, 336 participated in the study. In the research paper, there is no any data missing the writer was cover all the important statistical data which are relevant to the research paper.
In addition to that, a writer mentioned all the numbers, percentage, statistical values accurate and all clear. For example, the consensus panel was reviewed the 153 cases, 41 cases of dementia and the remaining 38 cases of MCI were diagnosed. For dementia cases, 17 were divided as mild, 12 were moderate and other 12 as severe studied by American Psychiatric Association in 1987. So this data proves that the writer provided appropriate statistical data in the research paper. All the statistical tests have been used in the research paper were more suitable and inappropriate manners. Furthermore, the sample which is used to study the statistical value is large enough to specify all information regarding dementia. In the end, the result which is provided by the author is believable. The crude prevalence of dementia was 13. 4% and the age-standard rate was 21. 0 %. The study shows that dementia prevalence at different age group in the present study and the previous study in a regional or urban Aboriginal population and officially its estimated for the general Australian populations (AIHW, 2012). Thus the total amount of cognitive impairments was 32. 3% in their populations.
Discussion and conclusion
The author used the methodology to discuss and critique the article by the appropriate way and mentioned every information regarding the article in easily understandable by a reader. The study’s discussion part is the greatest and most important section of the framework. This section also summarized the strength of study and limitations and how that was addressed in the study. The researchers made this research a higher standard of epidemiological work. It is seen that investigators are trying to the bias of the study to make it more flexible.
For example, researchers studied that during phase 1 of the study the dementia index was not large enough and not catch out the precise data so they studied more and conducted phase 2. The author mentioned that the prevalence of dementia in the present Aboriginal populations was compared with the rate which is found in a remote population at age group between 60 years and more. The results are discussed comprehensively and not mentioned any important literature on the topic. The discussion extended after the results of the study. The researchers also involved the issues that connect with higher prevalence and incidence of dementia and in Indigenous Aboriginal Australians. The study shows that Education is an important parameter for health and fight with the disability.
The study also represents the health issues in Aboriginals likewise midlife disease rates and social and biological risk factors which have the adverse effect that all are the major contributors to accelerated morality in Aboriginal communities. Using important literature, the discussion is also compared with different states of Western Australia and conducted studies in Perth, New South Wales, and Sydney. The study provides a strong message that Aboriginal's dementia is high and come at the earlier stage compared with a different ethnic group. A conclusion of the study reflected the result of the study. It also for an urgent action to label the emerging issue in regional Aboriginal and Australia’s people. This is also a high point of an epidemiological study. The conclusion was clearly set out.
