Innovative tool revolutionises dementia diagnosis for Māori kaumātua

A groundbreaking tool is poised to revolutionise the diagnosis of mate wareware (dementia) in Māori kaumātua.

The Māori Assessment of Neuropsychological Abilities or MANA has been developed by Māori researchers and led by principal investigator Dr Makarena Dudley, a psychologist from Waipapa Taumata Rau, University of Auckland.

The MANA tool is a significant step towards culturally sensitive and comprehensive dementia diagnosis, an add on to the current diagnosis system in Aotearoa New Zealand.

The tool emerged from a bottom-up approach, engaging with the korerō of up to 300 kaumātua and whānau who generously shared their insights and experiences of mate wareware.

Comprising three integral components — Wairua and Wellbeing, Whānau Functional, and Cognitive — MANA offers a holistic perspective that aligns with Te Ao Māori, incorporating spiritual and familial dimensions into the diagnostic process.

Dudley, who is also the Deputy Dean Māori for the University’s Centre for Brain Research, emphasises that MANA is an empowering option for kaumātua undergoing diagnosis.

"It's a tool that enhances the current diagnosis system in Aotearoa New Zealand, providing a culturally responsive approach,” she says.

The current system involves a comprehensive assessment encompassing initial assessments, medical evaluations, cognitive assessments, laboratory tests, imaging studies, specialist referrals, dementia diagnosis, and post-diagnosis support.

“Stress often goes hand-in-hand with this type of assessment,” says Dudley. “We have included practices of tikanga Māori when using the MANA tool to provide an enivronment that will reduce stress and get the best out of the person being tested.”

MANA, now sanctioned by Te Whatu Ora’s Health of Older People committee, will be integrated into the agency’s pathways, allowing clinicians to use it when diagnosing mate wareware in Māori patients.

The MANA tool is scheduled for a public launch at Waipapa Taumata Rau, the University of Auckland, on 12 December at 2pm in the University’s Faculty of Medical and Health Sciences.

MANA will then be accessible on the NZ Dementia Foundation website for free use with the aim of encouraging its widespread adoption and understanding of its benefits.

Dr Dudley says it will give people an opportunity to learn and understand the benefits of the tool, fostering awareness and acceptance within our communities."

“The introduction of the MANA into the dementia diagnostic pathway will enhance accessibility for Māori who may be reluctant to engage in the current process based within a western worldview.”

The research team behind MANA is a diverse group of clinicians, researchers, and academics. It includes Dr Oliver Menzies, Associate Professor Nick Garrett, Professor Denise Wilson, Dr Hinemoa Elder, Dr Waiora Port, Professor Lynette Tippett, Dr Gary Cheung, Professor Ngaire Kerse, and Associate Professor Sarah Cullum.