Alzheimer’s Disease Knowledge Among American Indians: The Role of Social Determinants of Health

American Indian populations experience a disproportionately high prevalence of risk factors for Alzheimer’s disease and related dementias. This study assessed Alzheimer’s disease knowledge across seven domains and identified factors associated with overall and domain-specific Alzheimer’s 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’s disease knowledge across seven domains. Multivariable regression analyses were performed to examine factors associated with overall Alzheimer’s disease knowledge and each domain. Participants demonstrated 63.5% accuracy in overall Alzheimer’s disease knowledge (M = 18.7, SD = 4.1), indicating a moderate level of knowledge. Knowledge varied across domains: participants were most knowledgeable about the life impact of Alzheimer’s 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’s 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—particularly regarding risk factors and symptoms—suggest priority areas for Alzheimer’s 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’s disease knowledge and support Alzheimer’s disease prevention in American Indians.