Study finds non-physical worldviews common among cognitively healthy Ojibwe individuals

Visual hallucinations are common in people with dementia with Lewy bodies and other types of dementia. Identifying visual hallucinations is an important part of a wide variety of medical and psychiatric diagnoses and treatments, but without cultural context, some patients’ symptoms may be misinterpreted or misdiagnosed.

In the existing medical literature, there is almost no information regarding normal spiritual experiences in Native American participants in the context of neurocognitive assessment. Researchers at the University of Minnesota Medical School sought to understand how Ojibwe culture and spirituality affect a physician’s assessment of normal aging.

Published in Open JAMA Networkthe research team found that non-physical worldviews are common among cognitively healthy Ojibwe individuals and may represent normal spiritual experiences.

“Taking into account a patient’s cultural context and belief system can help avoid erroneous disqualification for disease-modifying treatment, exclusion from clinical trials, and all the negative ramifications associated with misdiagnosis of psychiatric illness ” said William Mantyh, MD, assistant professor at the University of Minnesota Medical School and behavioral neurologist at M Health Fairview.

In partnership with an Ojibwe Tribal Nation in Minnesota, the study recruited 33 cognitively healthy tribal elders aged 55 or older. The research found that 48% of participants reported frequent fleeting visions of the non-physical world, usually benevolent and involving spiritual beings and/or ancestors.

According to the research team, clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric illness.

“Today’s environment characterized by infrequent or insufficiently short cognitive assessments—an average 16-minute face-to-face visit with a physician—and increasing use of pre-visit symptom checklists increases risk to falsely attribute a spiritual experience to a hallucination,” Dr. Mantyh said.

The overarching goal of Dr. Mantyh and his research team is to ensure accurate diagnosis of neurodegenerative diseases in Native American communities. To achieve this goal, the research team is including Native American participants in the development of a new blood test for Alzheimer’s disease.

So far, more than 250 participants have been included. These new 95% accurate Alzheimer’s disease blood tests directly detect Alzheimer’s disease-related proteins in the blood, but they also look at a patient’s APOE ε4 gene. APOE ε4 is the most important genetic risk factor for Alzheimer’s disease, but its effect on Alzheimer’s disease depends on the patient’s ancestry.