{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:05:24Z","timestamp":1785416724612,"version":"3.56.0"},"reference-count":61,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000138","name":"U.S. Department of Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000138","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["U54GM128729"],"award-info":[{"award-number":["U54GM128729"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Dementia"],"abstract":"<jats:p>\n                    American Indian populations experience a disproportionately high prevalence of risk factors for Alzheimer\u2019s disease and related dementias. This study assessed Alzheimer\u2019s disease knowledge across seven domains and identified factors associated with overall and domain-specific Alzheimer\u2019s disease knowledge among American Indian adults. Guided by the social determinants of health framework, we conducted a cross-sectional survey of American Indian adults residing in South Dakota. A total of 227 participants completed a self-administered survey questionnaire measuring Alzheimer\u2019s disease knowledge across seven domains. Multivariable regression analyses were performed to examine factors associated with overall Alzheimer\u2019s disease knowledge and each domain. Participants demonstrated 63.5% accuracy in overall Alzheimer\u2019s disease knowledge (M = 18.7,\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    = 4.1), indicating a moderate level of knowledge. Knowledge varied across domains: participants were most knowledgeable about the life impact of Alzheimer\u2019s disease and least knowledgeable about risk factors and symptoms. Four domains were found to be statistically significant: disease course, treatment and management, risk factors, and caregiving. Higher educational attainment and employment status were significantly associated with greater overall Alzheimer\u2019s disease knowledge. Education was the most consistent factor associated with greater knowledge across all four domains, whereas other social determinants of health variables (e.g., social support from significant others, lower depressive symptoms, health status, exercise) showed domain-specific associations. Findings highlight the need for educational outreach and culturally tailored interventions grounded in the social determinants of health and responsive to American Indian community contexts. Notable gaps in knowledge\u2014particularly regarding risk factors and symptoms\u2014suggest priority areas for Alzheimer\u2019s disease prevention efforts. Health initiatives should address key social determinants, including education, employment, social support, health\/mental health status, and health behaviors. Interventions must be developed in partnership with Indigenous leaders and health professionals to ensure culturally relevant, community-driven, and holistic approaches that improve Alzheimer\u2019s disease knowledge and support Alzheimer\u2019s disease prevention in American Indians.\n                  <\/jats:p>","DOI":"10.1177\/14713012261471592","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:54:48Z","timestamp":1785120888000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Alzheimer\u2019s Disease Knowledge Among American Indians: The Role of Social Determinants of Health"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9394-2827","authenticated-orcid":false,"given":"Yeon-Shim","family":"Lee","sequence":"first","affiliation":[{"name":"San Francisco State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soonhee","family":"Roh","sequence":"additional","affiliation":[{"name":"University of South Dakota-Sioux Falls"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junghee","family":"Han","sequence":"additional","affiliation":[{"name":"University of Southern Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingyu","family":"Moon","sequence":"additional","affiliation":[{"name":"Georgian Court University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasheen T.","family":"Stone","sequence":"additional","affiliation":[{"name":"Yankton Sioux Tribe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald K.","family":"Warne","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.12611"},{"issue":"4","key":"e_1_3_6_3_1","first-page":"1598","article-title":"Alzheimer\u2019s disease facts and figures","volume":"19","author":"Alzheimer\u2019s Association","year":"2023","unstructured":"Alzheimer\u2019s Association. (2023). Alzheimer\u2019s disease facts and figures. Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association, 19(4), 1598\u20131695. https:\/\/doi.org\/10.1002\/alz.13016","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/dav022"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.12302"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2003.10399988"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.1012"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnp023"},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533317510394157"},{"issue":"2","key":"e_1_3_6_10_1","first-page":"567","article-title":"Lifestyle and genetic risk factors for Alzheimer\u2019s disease: A systematic review and meta-analysis","volume":"77","author":"Carty C. L.","year":"2020","unstructured":"Carty C. L., Ituarte P. H. G., Janssen I., Karasik D., Lian Y., Gershon A. K. (2020). Lifestyle and genetic risk factors for Alzheimer\u2019s disease: A systematic review and meta-analysis. Journal of Alzheimer\u2019s Disease, 77(2), 567\u2013580. https:\/\/doi.org\/10.3233\/JAD-200424","journal-title":"Journal of Alzheimer\u2019s Disease"},{"key":"e_1_3_6_11_1","volume-title":"Healthy brain initiative: Road map for American Indian & Alaska native peoples","author":"Centers for Disease Control and Prevention","year":"2024","unstructured":"Centers for Disease Control and Prevention. (2024). Healthy brain initiative: Road map for American Indian & Alaska native peoples. https:\/\/www.cdc.gov\/aging-programs\/php\/nhbi\/aian-peoples-road-map.html."},{"issue":"1","key":"e_1_3_6_12_1","first-page":"e33425","article-title":"The role of social determinants of health in promoting health equality: A narrative review","volume":"15","author":"Chelak K.","year":"2023","unstructured":"Chelak K., Chakole S. (2023). The role of social determinants of health in promoting health equality: A narrative review. Cureus, 15(1), Article e33425. https:\/\/doi.org\/10.7759\/cureus.33425","journal-title":"Cureus"},{"key":"e_1_3_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-8037-x"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/24705470221149479"},{"key":"e_1_3_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2026.118971"},{"key":"e_1_3_6_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S282147"},{"key":"e_1_3_6_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2016.1201174"},{"key":"e_1_3_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363461513487669"},{"key":"e_1_3_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70148"},{"key":"e_1_3_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2025.102800"},{"key":"e_1_3_6_21_1","volume-title":"Indian Health Service increases Alzheimer\u2019s and dementia care support during world Alzheimer\u2019s Month","author":"Indian Health Service","year":"2025","unstructured":"Indian Health Service. (2025, September 17). Indian Health Service increases Alzheimer\u2019s and dementia care support during world Alzheimer\u2019s Month. https:\/\/www.ihs.gov\/newsroom\/pressreleases\/2025-press-releases\/indian-health-service-increases-alzheimers-and-dementia-care-support-during-world-alzheimers-month\/."},{"key":"e_1_3_6_22_1","volume-title":"Intervention for Native American caregivers of elders with memory loss (INTACT)","author":"Institute for Research and Education to Advance Community Health, Washington State University","unstructured":"Institute for Research and Education to Advance Community Health, Washington State University. (n.d.). Intervention for Native American caregivers of elders with memory loss (INTACT). Institute for Research and Education to Advance Community Health, Washington State University. https:\/\/ireach.wsu.edu\/projects\/intact\/"},{"key":"e_1_3_6_23_1","volume-title":"Ideas for tribal public health approaches to address dementia","author":"International Association for Indigenous Aging","year":"2022","unstructured":"International Association for Indigenous Aging. (2022, July 28). Ideas for tribal public health approaches to address dementia. International Association for Indigenous Aging. https:\/\/iasquared.org\/2022\/07\/28\/5645-2\/"},{"key":"e_1_3_6_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0898264309360672"},{"issue":"1","key":"e_1_3_6_25_1","first-page":"5","article-title":"Alzheimer\u2019s disease knowledge among American Indians and Alaska natives","volume":"39","author":"Jernigan V. B. B.","year":"2020","unstructured":"Jernigan V. B. B., D\u2019Amico E. J., Duran B., Buchwald D. (2020). Alzheimer\u2019s disease knowledge among American Indians and Alaska natives. Journal of Applied Gerontology, 39(1), 5\u201314. https:\/\/doi.org\/10.1177\/0733464819866452","journal-title":"Journal of Applied Gerontology"},{"issue":"6","key":"e_1_3_6_26_1","first-page":"426","article-title":"Level of understanding of Alzheimer disease among caregivers and the general population","volume":"36","author":"Jorge C.","year":"2021","unstructured":"Jorge C., Ceto M., Arias A., Blasco E., Gil M. P., L\u00f3pez R., Dokters\u2019d F., Poroy F., Pi\u00f1ol-Ripoll G. (2021). Level of understanding of Alzheimer disease among caregivers and the general population. Neurology, 36(6), 426\u2013432. https:\/\/doi.org\/10.1016\/j.nrleng.2018.03.004","journal-title":"Neurology"},{"key":"e_1_3_6_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_6_28_1","volume-title":"The health literacy of America\u2019s adults: Results from the 2003 national assessment of adult literacy (NCES 2006\u2013483)","author":"Kutner M.","year":"2006","unstructured":"Kutner M., Greenberg E., Jin Y., Paulsen C. (2006). The health literacy of America\u2019s adults: Results from the 2003 national assessment of adult literacy (NCES 2006\u2013483). U.S. Department of Education, National Center for Education Statistics. https:\/\/nces.ed.gov\/pubs2006\/2006483.pdf"},{"key":"e_1_3_6_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.3.498"},{"key":"e_1_3_6_30_1","doi-asserted-by":"publisher","DOI":"10.2196\/14088"},{"key":"e_1_3_6_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/13557858.2022.2045907"},{"key":"e_1_3_6_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648261459708"},{"key":"e_1_3_6_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaa102"},{"key":"e_1_3_6_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daaa072"},{"key":"e_1_3_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1886-3"},{"key":"e_1_3_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"e_1_3_6_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/07317115.2014.990600"},{"key":"e_1_3_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2021.05.005"},{"key":"e_1_3_6_39_1","volume-title":"The American Indian\/Alaska native population in the U.S.: Key demographics and characteristics","author":"National Council on Aging","year":"2023","unstructured":"National Council on Aging. (2023, January 10). The American Indian\/Alaska native population in the U.S.: Key demographics and characteristics. National Council on Aging. https:\/\/www.ncoa.org\/article\/american-indians-and-alaska-natives-key-demographics-and-characteristics"},{"key":"e_1_3_6_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-82187-z"},{"key":"e_1_3_6_41_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-180439"},{"key":"e_1_3_6_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1540415319893238"},{"key":"e_1_3_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2019.100357"},{"issue":"1","key":"e_1_3_6_44_1","first-page":"1","article-title":"Association of lifestyle and vascular risk factors with Alzheimer\u2019s disease biomarkers and cognition","volume":"27","author":"Racine A. M.","year":"2021","unstructured":"Racine A. M., Koscik R. L., Berman S. E., Nicholas C. R., Clark L. R., Okonkwo O. C., Oh J. M., Gallagher C. L., Carlsson C. M., Bendlin B. B., Asthana S., Hermann B. P., Sager M. A., Johnson S. C. (2021). Association of lifestyle and vascular risk factors with Alzheimer\u2019s disease biomarkers and cognition. Journal of the International Neuropsychological Society, 27(1), 1\u201313. https:\/\/doi.org\/10.1017\/S135561772000078X","journal-title":"Journal of the International Neuropsychological Society"},{"key":"e_1_3_6_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnae072"},{"key":"e_1_3_6_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-022-01193-z"},{"key":"e_1_3_6_47_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2019.34"},{"key":"e_1_3_6_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.13354"},{"key":"e_1_3_6_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2023.102027"},{"key":"e_1_3_6_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23308"},{"key":"e_1_3_6_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbz112"},{"key":"e_1_3_6_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnab182"},{"key":"e_1_3_6_53_1","article-title":"Epidemiology and prevalence of dementia and Alzheimer\u2019s disease in American Indians: Data from the strong heart study","author":"Suchy-Dicey A. M.","year":"2024","unstructured":"Suchy-Dicey A. M., Domoto-Reilly K., Nelson L., Jayadev S., Buchwald D. S., Grabowski T. J., Rhoads K. (2024). Epidemiology and prevalence of dementia and Alzheimer\u2019s disease in American Indians: Data from the strong heart study. Alzheimer\u2019s & Dementia. Advance online publication. https:\/\/doi.org\/10.1002\/alz.13849","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"e_1_3_6_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10823-014-9229-6"},{"key":"e_1_3_6_55_1","volume-title":"Facts for features: American Indian and Alaska native heritage month: November 2022","author":"U.S. Census Bureau","year":"2022","unstructured":"U.S. Census Bureau. (2022, October 11). Facts for features: American Indian and Alaska native heritage month: November 2022. U.S. Census Bureau. https:\/\/www.census.gov\/newsroom\/facts-for-features\/2022\/aian-month.html"},{"key":"e_1_3_6_56_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1681041"},{"key":"e_1_3_6_57_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-200704"},{"key":"e_1_3_6_58_1","volume-title":"Social determinants of health","author":"World Health Organization (WHO)","year":"2025","unstructured":"World Health Organization (WHO). (2025). Social determinants of health. https:\/\/www.who.int\/health-topics\/social-determinants-of-health#tab=tab_1."},{"key":"e_1_3_6_59_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03955-6"},{"key":"e_1_3_6_60_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0327346"},{"key":"e_1_3_6_61_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327752jpa5201_2"},{"key":"e_1_3_6_62_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70279"}],"container-title":["Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14713012261471592","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14713012261471592","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14713012261471592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:46:33Z","timestamp":1785415593000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14713012261471592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":61,"alternative-id":["10.1177\/14713012261471592"],"URL":"https:\/\/doi.org\/10.1177\/14713012261471592","relation":{},"ISSN":["1471-3012","1741-2684"],"issn-type":[{"value":"1471-3012","type":"print"},{"value":"1741-2684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]},"article-number":"14713012261471592"}}