老年人群中的阿尔茨海默病（AD）和相关性痴呆（ADRD）是日益引起公共卫生关注的问题，无论种族或族群，它们都在持续增加。AD和ADRD的成因包括多种因素，如遗传突变、可改变和不可改变的危险因素以及生活方式等。对已故脑部进行的研究揭示了与AD和ADRD有关的多种细胞变化，包括淀粉样蛋白β和磷酸化tau的积累、突触损伤、炎症反应、激素失衡、线粒体异常和神经细胞丧失。这些变化既发生在早发家族性形式中，也发生在晚发散发性形式中。三分之二的女性和三分之一的男性终身患有AD的风险。大部分AD病例的病因与淀粉样前体蛋白、前基因1和前基因2基因的遗传突变有关，而APOE4等位基因则是一个危险因素。已对几乎所有种族群体人群进行了关于AD/ADRD以及糖尿病、肥胖症、高血压和癌症等共病的广泛研究，然而对美国土著居民进行的生物医学研究却非常有限。AD/ADRD在所有种族群体中的患病率都很高。此外，美国土著居民更难获得医疗保健和医疗服务，并且一旦他们开始出现症状，他们更不太可能得到诊断，这就导致了治疗阿尔茨海默病和其他痴呆症的困难。五分之一的美国土著居民中，45岁及以上的人报告存在记忆问题。此外，照顾者和其他医疗方面对美国土著居民的影响还不为人所知。在本文中，我们讨论了美国土著居民的历史和卫生差距，AD/ADRD的发生和患病率，并探讨了在美国土著居民中文化敏感的护理实践。本文是第一篇讨论与AD和ADRD相关的美国土著居民的生物医学研究和医疗差距的文章，我们还讨论了美国土著居民为何不愿参与生物医学研究。版权所有©2023 Elsevier B.V.发表。

Alzheimer's disease (AD) and Alzheimer's related dementias (ADRD) are growing public health concerns in aged populations of all ethnic and racial groups. AD and ADRD are caused by multiple factors, such as genetic mutations, modifiable and non-modifiable risk factors, and lifestyle. Studies of postmortem brains have revealed multiple cellular changes implicated in AD and ADRD, including the accumulation of amyloid beta and phosphorylated tau, synaptic damage, inflammatory responses, hormonal imbalance, mitochondrial abnormalities, and neuronal loss. These changes occur in both early-onset familial and late-onset sporadic forms. Two-thirds of women and one-third of men are at life time for AD. A small proportion of total AD cases are caused by genetic mutations in amyloid precursor protein, presenilin 1, and presenilin 1 genes, and the APOE4 allele is a risk factor. Tremendous research on AD/ADRD, and other comorbidities such as diabetes, obesity, hypertension, and cancer has been done on almost all ethnic groups, however, very little biomedical research done on US Native Americans. AD/ADRD prevalence is high among all ethnic groups. In addition, US Native Americans have poorer access to healthcare and medical services and are less likely to receive a diagnosis once they begin to exhibit symptoms, which presents difficulties in treating Alzheimer's and other dementias. One in five US Native American people who are 45 years of age or older report having memory issues. Further, the impact of caregivers and other healthcare aspects on US Native Americans is not yet. In the current article, we discuss the history of Native Americans of United States (US) and health disparities, occurrence, and prevalence of AD/ADRD, and shedding light on the culturally sensitive caregiving practices in US Native Americans. This article is the first to discuss biomedical research and healthcare disparities in US Native Americans with a focus on AD and ADRD, we also discuss why US Native Americans are reluctant to participate in biomedical research.Copyright © 2023. Published by Elsevier B.V.