While there is strong evidence of the need for healthy ageing programs for older Aboriginal Australians, few are available. It is important to understand older Aboriginal Australians’ perspectives on healthy ageing in order to co-design culturally-appropriate programs, including views on technology use in this context. Semi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ health concerns, preferences for healthy ageing programs, and receptiveness to technology. Qualitative data were analyzed using a grounded theory approach. This study found that older Aboriginal Australians are concerned about chronic health conditions, social and emotional well-being, and difficulties accessing health services. A range of barriers and enablers to participation in current health programs were identified. From the perspective of older Aboriginal people, a successful healthy ageing program model includes physical and cognitive activities, social interaction, and health education. The program model also provides culturally safe care and transport for access as well as family, community, cultural identity, and empowerment regarding ageing well as central tenets. Technology could also be a viable approach for program delivery. These findings can be applied in the implementation and evaluation of culturally-appropriate, healthy ageing programs with older Aboriginal people.

BackgroundWhile there is strong evidence of the need for culturally appropriate healthy ageing programs for older Aboriginal Australians, there are few such available programs. There is also emerging potential and advantages of using technology as a platform for program delivery. It is important to understand older Aboriginal Australians’ perceptions of healthy ageing in order to co-design culturally appropriate healthy ageing programs, including views on technology use in this context.MethodsSemi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ main health concerns, preferred approaches to developing healthy ageing programs, and receptiveness to technology. Qualitative data were analysed using a grounded theory approach. ResultsThis study found that older Aboriginal Australians are concerned about chronic health conditions; social and emotional wellbeing; and difficulties accessing health services. Barriers to participation in current health programs included unappealing programs, disengagement due to past negative experiences, shame or stigma, and a sense of disempowerment. Flexibility of attendance and social aspects emerged as enablers. From the perspective of older Aboriginal people, a successful model of a healthy ageing program is one that comprises physical and cognitive activities, social interaction and health education, while providing culturally safe care and transport. Such a model should maintain family, community, cultural identity and empowerment regarding ageing well as its central tenets. This study also provides preliminary evidence of the viability of technology as a platform for health program delivery amongst older Aboriginal people in urban and regional settings. ConclusionFuture research may apply these findings in the implementation and evaluation of culturally appropriate healthy ageing programs for older Aboriginal people.

Objectives Cognitive screening via telehealth is increasingly employed, particularly during the COVID‐19 pandemic. Telephone adaptations of existing cognitive screening tests must be validated across diverse populations. The present study sought to evaluate an existing 26‐point telephone adaptation of the Mini‐Mental State Examination (tMMSE) in a sample of older Aboriginal Australians. Additionally, we aimed to evaluate a telephone adaptation of the urban version of the Kimberley Indigenous Cognitive Assessment short‐form (tKICA screen). Methods A sub‐sample (n = 20) of participants (aged 55–69 years; 11 women) who had completed an in‐person cognitive assessment (MMSE and KICA screen) within the past 6 months as part of the Koori Growing Old Well Study completed telephone‐based cognitive testing without an assistant. Results There was moderate correlation and reasonable agreement between MMSE versions (rs = 0.33; p = 0.2), although the limits of agreement were unacceptably wide (−4.1 and 4.8 points difference). Poorer performance was seen on the tMMSE for Season (p = 0.02) and Phrase (p = 0.02) items, and better performance for three‐word Recall (p = 0.03). KICA‐screen versions were poorly correlated (rs = 0.20; p = 0.4) with telephone scoring a mean of 2.17 points below the face‐to‐face score, greater bias observed at the lower end of the performance and worse scores for Season (p = 0.02) and Recall (p = 0.001) items. Age and education were not associated with telephone screening performance. Hearing impairment was associated with poorer performance on the tKICA screen (p = 0.04) but not the tMMSE (p = 0.6). Conclusions Results indicate that telephone administration of the MMSE and/or KICA screen is not equivalent to in‐person testing for older Aboriginal people, and further revision and evaluation are required.

Background Cognitive assessment via telehealth is being increasingly employed, particularly in the context of the COVID‐19 pandemic. Widespread access to video call software has improved the availability and quality of telehealth services however inequity of access to such technologies remains for some communities, especially when restricted to home‐based telehealth options. As such, telephone adaptations of existing cognitive screening tests need to be validated across diverse populations. Method The present study sought to evaluate an existing 26‐point telephone adaptation of the Mini Mental State Examination (TMMSE) in a sample of older Aboriginal Australians. Additionally, we aimed to evaluate a novel urban telephone adaptation of the Aboriginal‐specific Kimberly Indigenous Cognitive Examination short form (TKICA‐screen). A sub‐sample (n=20) of participants (age range: 55‐69 years; MMSE range: 23‐30), who had completed in‐person cognitive assessment (MMSE and KICA‐screen) within the past 6 months as part of the Koori Growing Old Well Study, completed telephone‐based cognitive testing using the TMMSE and TKICA‐screen. Result There was a moderate positive correlation between MMSE versions (r=.583; p=.011) with poorer performance on the TMMSE for Season (p=.016) and Phrase (p=.016) items. A weak correlation was observed between the KICA‐screen and TKICA‐screen (r=.196; p=.407) with participant’s performing significantly worse on the TKICA‐screen for Season (p=.016) and Picture Recall (p=0.001). Demographic factors, including age, sex and education were not associated with telephone screening performance. Participants with hearing problems performed worse than those without on the TKICA‐screen (p=.042), but there was no significant difference found on TMMSE (p=.609). Conclusion This small pragmatic study had a number of limitations, but preliminary results indicate that the TMMSE may be a suitable alternative to the in‐person test in this population. However, the TKICA‐screen requires further revision and evaluation. Clinically, service‐to‐service video telehealth has enabled the continuation of geriatric medicine and dementia outreach clinics to rural Aboriginal community controlled health services throughout pandemic‐related public health restrictions. There is potential for telehealth services to enhance remote access to culturally safe dementia assessment, diagnosis and specialist care services for older Aboriginal Australians, but further research is required, particularly validation of cognitive assessment approaches.