Dementia is no longer a distant concern for future generations – it is here, growing, and already affecting whānau across Aotearoa. Known in te reo Māori as mate wareware, this condition involves progressive decline in memory and cognition. It affects not just the person living with it, but their whanau, community, and cultural wellbeing.
In New Zealand, recent research shows that dementia is under-recognised, with up to half of those who live with memory problems unaware they have the condition.
For Māori, the challenge is even more pronounced. Māori are often diagnosed younger, experience earlier onset, and can face significant barriers in accessing appropriate diagnosis and support – particularly in rural areas where health services are scarce.
That’s why the work of Dr Makarena Dudley – clinical neuropsychologist, researcher and Member of the New Zealand Order of Merit – is so vital. Dr Dudley has dedicated years to understanding mate wareware from a Māori perspective and creating programmes that work for Māori, by Māori.
Across Aotearoa, the ageing population means more people will develop dementia in the decades to come. Māori are expected to see an even sharper rise in prevalence, partly because of higher rates of associated health conditions – like cardiovascular disease and diabetes – and higher rates of social disadvantage that increase risk.
Māori also face a lived reality where signs of mate wareware are frequently misunderstood. Early symptoms are sometimes dismissed as “just old age” or getting forgetful rather than signals that require support and care.
For many Māori whānau, caregiving is taken on within the household in keeping with cultural values of manaaki and whānau responsibility. But without support, this can become an exhausting and isolating burden. Research shows that in some rural Māori communities, carers may go years without formal diagnosis, support, or even basic information to help them.
Dr Makarena Dudley’s work represents a shift from a purely Western clinical model to one rooted in te ao Māori – recognising that cognition, identity, whānau, wairua (spiritual wellbeing) and culture are inseparable in how dementia is experienced and managed.
Her research has shown that Māori concepts of identity, connection and cultural activity – like participation in marae life, karakia and waiata – can be protective factors for brain health and wellbeing. These activities help stimulate neurological pathways and maintain connection with cultural identity even as cognitive changes occur.
Māori whānau often prefer to care for kaumātua at home, in environments where language and cultural values reinforce belonging and dignity. This contrasts with standard care models that place elders in unfamiliar, culturally insensitive settings.
Tools such as the MANA assessment – developed with a Māori worldview in mind – aim to improve diagnosis by asking questions meaningful to Māori clients and whānau.
Dr Dudley’s approach is about bringing together mātauranga Māori and Western science – so that whānau are understood, supported and strengthened at every stage of the mate wareware journey.
While dementia cannot yet be cured, earlier detection and culturally responsive care can dramatically improve quality of life – for both people living with mate wareware and their whānau.
A recent nationwide study found many New Zealanders are living with dementia without knowing it, which limits access to care and support.
Dr Dudley and her colleagues are also working on Māori-specific therapy programmes – such as Haumanu Whakaohooho Whakaaro Māori, which uses Māori cultural activities and marae environments to ground cognitive stimulation in familiar, meaningful contexts.
But there is still much work ahead. Whānau across Aotearoa, especially in rural areas, need better access to diagnosis, support services, and education about the signs of mate wareware. And addressing the root causes of dementia risk – including poverty, poor access to healthcare and chronic disease – is essential for long-term wellbeing.
Dementia is not solely a medical issue – it’s a social, cultural and community issue. When kaumātua living with mate wareware lose memory, they can also lose connection to te reo, to whakapapa, to stories and to the lived wisdom that binds generations.
By listening to whānau, using culturally responsive tools, and supporting Māori-driven solutions like those championed by Dr Makarena Dudley, we all have a part to play in ensuring dignity, identity and care for those living with dementia and those who love them.
Hear more from Dr Makarena Dudley in the full Radio Waatea interview: https://waateanews.com/2025/11/06/dr-makarena-dudley-leading-maori-neuropsychologist/
