Need a PDF?
As an older indigenous person, this resource is for you and your family. It includes information for people from any tribe in the United States. You might have higher risks for some diseases because of your genetics, health habits, bias in the healthcare system, or your environment. The biggest health problems for older American Indian and Alaskan Natives (AIANs) are diabetes, coronary artery disease, renal failure, and an increased risk of amputation.
When you visit your healthcare professional, let them know about your health needs and questions you may have. Your healthcare professionals need to know because they want to give you good care and keep you as healthy as possible. You can also let your provider know about traditions, stories, beliefs, or practices if you feel comfortable and can share that information.
We will discuss some high-risk diseases among AIANs and tips to talk with your healthcare professional about your health care.
Special Healthcare Concerns of Older Native American and Alaskan Native People
Diabetes causes high blood sugar levels and leads to other health problems. These may include damage to your eyes, kidneys, heart, and feet.
Your healthcare professional will check your blood sugar, blood pressure, cholesterol, and kidney function. You need to check your feet daily and report any skin problems to your healthcare professional immediately. AIAN people have a higher risk of having serious health problems resulting from diabetes. These problems can include:
- Chronic Kidney Disease. This may develop slowly with few signs of the disease. So, you need to get your kidneys checked regularly with simple blood and urine tests. You can help maintain your kidneys’ health by keeping your blood sugar controlled, checking your blood pressure regularly, and having your A1C levels tested at least twice per year. (Your A1C value helps your doctor know how high your blood sugar has been over the last 3 months.)
- Eye Disease. Diabetes can cause you to lose your sight. You need to have a healthcare professional check your eyes at least once a year. If they find problems early, they can help you protect your eyesight. Also, see your healthcare professional if you notice changes in your eyesight, like blurring, spots, or flashes.
- Foot Problems. Diabetes can also cause problems with your feet, like numbness, wounds, pain, and swelling. You need to check your feet every day and see your healthcare professional if you notice any changes. If you don’t receive treatment for these problems, you may need an amputation (removal of your foot or part of your leg).
Diabetes can get worse if you eat unhealthy food, do little exercise, or have overweight or obesity. Talk with your healthcare professional about how to eat healthily, exercise, and take the medications you may need. Some tips include:
- Decrease carbohydrates in your diet, such as white bread and pasta
- Eat more vegetables and low calorie foods
- Drink water (preferred) or sugar-free beverages instead of sugary beverages
- Increase your exercise. It is recommended to exercise for 30 minutes per day, five days a week, but any amount of physical activity is good for your health. Physical activity is helpful in keeping your blood sugar under control, among other benefits.
Coronary artery disease is one form of heart disease. It happens when plaque (a waxy substance made up of cholesterol) builds up in the walls of the arteries that take blood to the heart. This buildup causes the inside of the arteries to become narrow. Eventually the plaque can block the blood flow. This process is called atherosclerosis.
Your risk of having a heart attack or stroke is higher if you have high blood pressure, heart failure, diabetes, obesity, smoking, and do little physical activity.
Eating foods low in fat and salt and getting daily exercise can reduce your chances of having heart disease and strokes. Quitting smoking, controlling blood pressure, and taking recommended medications also helps you avoid these health problems. Talk to your healthcare professional about how to reduce your risks and follow their advice.
Be aware of immediate risks to your health. If you have chest pain and/or shortness of breath, you might be having a heart attack. If so, you need to call 911 or go to the nearest emergency room right away. Strokes happen when the brain’s blood supply is blocked or stopped. Brain cells can die within minutes. If you have trouble speaking, weakness on one side of your body, severe headache, or loss of vision or balance you need to call 911 or go to the nearest emergency room right away.
There are several factors that affect AIAN communities which can increase the risk of developing alcohol addiction. Drinking too much alcohol as an older adult may lead to higher risks of falls or other injuries, as well as impact other health conditions you may have. It is recommended that older men have no more than two drinks in one day, and older women have no more than one drink in one day. Drinking less alcohol is better for your health than drinking more. The Alcohol and Substance Abuse Branch of the Indian Health Service has resources specific to AIAN people interested in
programs to help them with alcohol or substance use issues.
Preventing or discovering disease can limit damage to your body. Seeing your healthcare professional at least once a year will help you discover diseases early so that they are easier to treat and you have better results.
Your healthcare professional will discuss preventive healthcare with you. For example:
- Cancer screenings are important. Some common screening tests are mammograms, prostate exams, and colonoscopies.
- Vaccinations, including flu, pneumonia, shingles, and COVID-19 shots, can prevent serious infections. If you are concerned about getting vaccinations, ask your healthcare professional for more information.
- Let your healthcare professional and pharmacists know if you take home remedies, herbs, vitamins, or supplements. These professionals can help make sure these remedies are safe with your other medications and treatments.
Your healthcare team can include physicians, nurse practitioners, physician assistants, nurses, nursing assistants,
social workers, pharmacists, therapists, and others. Each team member has special training to help you in different ways.
Your healthcare team will want to know about you, and what is important to you!. If you feel comfortable sharing information about your cultural beliefs and practices with your healthcare team you can work together to receive the best care possible.
See the Tip Sheet on Cultural Considerations when Communicating with Your Healthcare Team for helpful suggestions.
We hope this information has been helpful to you. Be sure to let your healthcare providers know if you or your family members have any questions.
Last Updated June 2025