Makarena Dudley. Photo: University of Auckland / Supplied
A new assessment tool is poised to revolutionise the diagnosis of mate wareware (dementia) in Māori kaumātua.
The Māori Assessment of Neuropsychological Abilities (MANA) emerged from the korerō of up to 300 kaumātua and whānau, who shared their insights and experiences of mate wareware.
Principal investigator Dr Makarena Dudley said there was nothing in any of the current diagnostic tools that incorporated a Māori worldview.
"I have become acutely aware that these tools are not designed to bring out the best in Māori and so they have a cultural bias, an inherent cultural bias in them because they have been developed in a Western paradigm."
Dudley said the challenge when creating MANA was making sure the integrity of the clinical diagnosis was upheld while being relevant and acceptable to Māori - an exercise in walking down the middle of two knowledge bases: Western and Māori.
Made up of three components, MANA incorporated wairua (spiritual), whānau (familial) and cognitive dimensions into the diagnostic process, offering a comprehensive and culturally sensitive approach.
"We have included a component which is unique compared to any other tool used for this purpose in the world, and that is a wairua component," Dudley said.
"And that is in response to the call from the many, the hundreds of kaumātua in fact, that we talked to around the motu who said to us what was missing when they went and saw the doctors was that the doctors never asked them about their spirituality, about their wairua."
And so the wairua component is the first component that clinicians should use when speaking to their patients, Dudley said.
"It allows the kaumātua or the person being assessed to develop some sort of trust in the clinician as well, and really to be able to talk about what is most important to them."
Dudley said there was anecdotal evidence to support the fact a lot of kaumātua with dementia were going undiagnosed.
But she said the prevalence of dementia among Māori was guesswork at the moment because there had not been a nationwide study. That was something she hoped would change soon, with a national prevalence study getting underway in February next year.
"We will be going throughout the motu to get a more accurate picture of the extent of mate wareware in the community. At the moment it's kind of guesswork really, based on studies that have been done on other indigenous peoples in other countries or on very small studies that have been conducted here in New Zealand."
What was known was that Māori were over-represented in other factors such as diabetes, heart disease and smoking rates, all of which increase the likelihood of dementia, she said.
"Mate wareware, dementia can be prevented with lifestyle changes. If we modify some of the behaviours in our life if we lead a healthy life overall, people are able or the community are able to reduce the onset of mate wareware by up to 40 percent."
