THE PROBLEM OF DEMENTIA IN AUSTRALIAN ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITIES - AN OVERVIEW

The concept of dementia in old age in Australian Aboriginal and Torres Strait Islander communities is intrinsically paradoxical. Firstly, fe w indigenous people reach old age. Secondly, from some indigenous poin ts of view, dementia is either not recognized as a condition or as a p roblem, or, in the case of the more disruptive manifestations of cogni tive impairment, is perceived as 'madness'. Moreover, in the wider con text of profound political, social and economic inequality experienced by most indigenous people, the western medical category of dementia m ay appear to be of relatively minor importance. However, government in itiatives in aged care generally and dementia care in particular which are designed to address the ageing of the Australian population as a whole also include the nation's older indigenous people. This article- based on a review of published work, supplemented by discussions with indigenous and non-indigenous individuals involved in indigenous aged care and mental health-examines some of the issues surrounding cogniti ve decline in old age for Aborigines and Torres Strait Islanders. More specifically, it looks at the problems involved in assessing and diag nosing cognitive decline and dementia, especially among people who fol low more traditional ways of life, and in providing services to suffer ers and their carers. In doing so, it considers some of the relative m eanings of 'old age', 'abnormal old age', 'mental disorder', 'sickness ' and 'dementia'.