By Rosemary Rangitauira 29/09/2021


A trained clinical neuropsychologist, Dr Makarena Dudley,  is part of a team developing a Māori-friendly tool to help diagnose dementia which is due to be available by mid-2022.

For many years, Makarena administered neuropsychological assessment tools, developed overseas, which she says haven’t always helped diagnose Māori patients.

She says the current assessment tools fail Māori.

“It became more and more difficult for me to administer these tools. In the back of my mind, I’d always consider the idea of developing a Māori friendly tool to aid mental health.”

Makarena, who hails from Te Rarawa, Te Aupōuri and Ngāti Kahu, is involved in the development of a tool called MANA, the Māori Assessment of Neuropsychological Abilities, for diagnosing mate wareware (dementia).

It will be used by clinicians and physicians and incorporates tikanga Māori (Māori protocols), Māori content and scoring criteria.

A senior lecturer at the University of Auckland, she says current neuropsychological methods cater to the general public but disempower minority cultures such as Māori.

“Generally, the types of psychometric tests carried out are formal and unfamiliar to Māori. The scoring criteria is problematic. So often Māori would be scored low. For example, one of the questions used is, what does terminate mean? The answer, according to the test, is to finish or complete something. But many of our Māori whanaunga (kin) would associate this word with killing so they are scored poorly.”

The MANA tool builds on an earlier project that Makarena has been involved in. It was developed following requests by kaumātua (Māori elders) and whānau Māori around the country who wanted to know more about mate wareware. Makarena also co-led the creation of an app called Mate Wareware. It was launched in March this year and can be downloaded to a smartphone or accessed via www.matewareware.co.nz.

Makarena says she and her team are in the final stages of validating the MANA tool.

“We are about 25 people away from validating it. We’re assessing patients using the tool but Delta has come along which has put a hold on testing.”

“We want to get the trials done by the end of the year and get the analysis completed for the tool to be available by the middle of 2022 for use by clinicians.”

Last year, Makarena published the initial research on MANA and in 2019 she and her colleagues on the project penned an article about the tool for the New Zealand Medical Journal.

Makarena has found her calling and is driven to improve the lives of Māori and their families living with mate wareware.

“This tool will have a huge impact on Māori which I’m so pleased about.”

She’s encouraging upcoming Māori researchers to consider neuropsychology as a career.

“At present, there are about a handful of Māori in the country who specialise in this area. We need more to provide care for our ageing Māori population because the current system doesn’t serve tāngata whenua well.”

Makarena Dudley is appreciative of the many kaumātua (Māori elders) and pākeke (adults) who contributed over the past eight years to research about mate wareware.

“More research needs to be done into this disease so that we can be prepared for the burgeoning number of kaumātua who will require health care services for conditions like mate wareware,” she says.

Bonus read

Dr Makarena Dudley represents New Zealand as a member of an international indigenous cognitive research network that includes Australia, America, Mexico and Canada. The International Indigenous Dementia Research Network meets regularly to discuss emerging rangahau (research), develop collaborations, explore funding opportunities and support each participating nation in this research field.

Makarena is also working on a therapeutic intervention programme called Cognitive Stimulation Therapy that promotes activity that stimulates thinking and memory and is designed for kaumātua in the early stages of dementia.

She thanks the many people who influenced her research path to mate wareware including Professor Ngaire Kerse and Professor Dianne McCarthy. Professor McCarthy lectured about the split-brain, which relates to a patient whose corpus callosum that connects both sides of the brain is separated but can process and respond independently.

Professor McCarthy’s lecture fascinated Makarena and led her to learn more about the brain.