Abstract Details

Title Cognitive Health Social Disparities in Shawi Indigenous Communities of the Peruvian Amazon: A Preliminary Analysis

Topic Global Health and Neuroepidemiology

Presentation(s) S4 - Hot Topics in Global Health and Neuroepidemiology (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Objective Our study assessed cognitive health among adults older than 50 years old in Shawi Indigenous communities of the Peruvian Amazon.

Background Indigenous populations in the Amazon have historically been excluded from health research, limiting available cognitive data. In the Peruvian Amazon, Shawi communities face major barriers to healthcare access due to language isolation, geographic remoteness, poverty, and the impacts of climate change.

Design/Methods We conducted a cross-sectional study in 40 Shawi villages in Loreto, Peru, enrolling 431 adults aged ≥50 years between November 2023 and February 2024. Our instruments were culturally adapted and translated into Shawi through forward-backward translation, expert review, and pilot testing. Cognitive performance was assessed using the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) and the Bolivian version of the Modified Mini-Mental State Examination (3MS). A subsample (n=196) of participants underwent a neurological examination by a specialist.

Results The median participant age was 59 years; 54.5% were female, 70% had no formal education, and about two-thirds were Shawi monolingual speakers. The prevalence of mild cognitive impairment and dementia was estimated in 11.8% and 1.9%, respectively. Lower cognitive scores were associated with depression and anxiety symptoms (p<0.05), lower functionality (p<0.001), lower BMI(p<0.001), and being monolingual (p<0.001). Our multilinear regression showed lower cognitive scores among females (β = –0.30, 95% CI: –0.45 to –0.16; p<.001) and those with less education (β = 0.13, 95% CI: 0.10 to 0.16; p<.001). Both sex and education explained 16% of cognitive scores’ variance.

Conclusions This is the first study to assess cognition in a predominantly monolingual Indigenous population in Peru. Findings highlight the role of social determinants of health in cognitive outcomes, and underscore the need for culturally tailored tools and interventions to address cognitive health and increase access to care in Indigenous Amazonian communities.

Authors/Disclosures
Monica M. Diaz, MD, MS (University of North Carolina at Chapel Hill) PRESENTER	The institution of Dr. Diaz has received research support from CorEvitas. The institution of Dr. Diaz has received research support from Novartis. The institution of Dr. Diaz has received research support from Bodford Family Transverse Myelitis Center Fund.
Arantxa N. Sanchez Boluarte, MD, MPH (UNIVERSIDAD PERUANA CAYETANO HEREDIA)	Dr. Sanchez Boluarte has received research support from NIH Fogarty International Center .
Alicia Boluarte, Psychology	Dr. Boluarte has nothing to disclose.
Danilo Sanchez Coronel (INCN)	Danilo Sanchez Coronel has nothing to disclose.
Joseph R. Zunt, MD (Harborview Medical Center)	The institution of Dr. Zunt has received research support from NIH. Dr. Zunt has received publishing royalties from a publication relating to health care.
Hector H. Garcia, MD, PhD	The institution of Hector H. Garcia, MD, PhD has received research support from NIH.

��ɫ��

��ɫ��