Clinical Assessment: Cognitive and Affective Status

Some Alaska Natives may refer to dementia as ‘becoming forgetful’, a condition that is seen as a natural consequence of aging. Studies that focus on the prevalence of dementia, Alzheimer’s, and depression have been widely neglected and understudied for Alaska Native older adult. Cultural values and perceptions need to be studied and the findings incorporated into practice.

The Mini-Mental Status Exam (MMSE) (modified for cultural relevancy and language consistency), the Indian Depression Schedule (IDS), and the Center for Epidemiological Studies Depression Scale (CES-D) have been used with internal consistency for this population. DSM IV Diagnostic Criteria for mental disorders may not be applicable as there are vast differences in cultural (tribal) beliefs about mental illness, cultural labeling of different emotions, and conceptual language differences (Manson et al., 1985).