Dementia is on the rise in New Zealand, but it is a condition many are afraid to talk about. In the fifth story of a Northern Advocate series, Denise Piper shines a light on how Alzheimer’s disease and other types of dementia impact Northlanders, the early warning signs and what
Dementia in Northland: Far North programmes focus on Māori and proven to help
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Dr Makarena Dudley, from the University of Auckland's Centre for Brain Research, helps deliver a Māori-specific programme proven to help improve patients with dementia mate wareware.
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Dudley admits the number can be arbitrary, as some people who suspect they might have a cognition problem might not be willing to be involved in research.
“Anecdotally, there are lots of Māori that are walking around with mate wareware, quite clearly, and have not got a diagnosis.”
As Māori are less likely to engage with regular health services and more likely to be impacted by the dementia risk factors, Dudley said it was important to have more culturally appropriate support.
She often encourages health workers to use marae, which is a familiar environment for Māori and somewhere they have known since childhood.
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“They feel safe and feel loved – they operate at optimum level.”
Dudley admits that among Māori, there is a stigma associated with dementia, but getting a diagnosis as early as possible can help people retain their mana and have more control over what is happening.
It also means people can access medications to help manage the condition if needed, such as if patients become violent.
“I visited one family and the woman was a darling but without medication, she was vicious. It enabled her to stay with her whānau and mokopuna, without being placed in a secure environment.”
Help at hand for mild to moderate mate wareware
Dudley has also adapted the only non-pharmaceutical intervention with proven evidence of slowing dementia progression, Cognitive Stimulation Therapy, giving it a Māori lens.
Haumanu Whakaohooho Whakāro – Māori is designed to improve memory and quality of life for Māori with mild to moderate mate wareware.
Run in small groups on marae or local halls, the 15-week programme gives multi-sensory stimulation and brain exercises, Dudley says.
For instance, a CD with noises on it might be played and participants must work out what the noise is, she says.
If something triggers a memory, participants are encouraged to reminisce and share how the memory made them feel.
“The kaumātua adore it ... At the end of the 15 weeks, they want to do it again,” Dudley says.
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“It’s really just continuing to use the braincells in a way we know works ... It keeps the neurons active.”
The only problem is Dudley cannot keep up with training requests, as she is the only person in New Zealand who can teach facilitators how to run the programme for Māori.
This is a common issue in an area where there is a lack of general health workers and researchers – the need is even greater for Māori, she says.
“There are not enough Māori health workers or researchers. At the university, I’m always looking around for students to be interested in the health of older people and train up,” Dudley says.
“As mate wareware becomes more prevalent in our society, there’s more students coming through.”
‘A lot of caregivers die from the act of caregiving’
Caregivers are also a focus for Dudley and the Centre for Brain Research, which is funding caregiver support programmes, run with the help of Māori health organisations like Te Hau Ora o Ngāpuhi.
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“We know, worldwide, caregiving can be very dangerous in terms of mortality, as a lot of caregivers die from the act of caregiving.”
The support groups are an easy and cheap way of helping caregivers and are run with a Māori framework so Māori feel comfortable taking part, she says.
“They’re really effective. People have said ‘if it wasn’t for this, I wouldn’t have survived’.”
While caring often falls on one person – usually the oldest daughter in Māori whānau – there can also be good things that come out of caregiving, Dudley says.
“There’s an experience and richness and growth that comes from caring for the family member with mate wareware. It doesn’t have to be all negative – there are some positive aspects which I think are just as important.”
How can the risk of dementia be reduced?
International research shows there are 14 risk factors that increase the risk of developing dementia.
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The Lancet Commission on dementia prevention, revised in 2024, found addressing all of these risks could prevent or delay 45% of dementia cases.
The risk factors cover all parts of life. In early life:
- less education.
Midlife:
- hearing loss
- high LDL cholesterol
- depression
- traumatic brain injury
- physical inactivity
- diabetes
- smoking
- hypertension
- obesity
- excessive alcohol.
Later life:
- social isolation
- air pollution
- visual loss.
Dudley said if people are able to change these behaviours, thousands of people could avoid getting mate wareware.
Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.
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