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Şener M, Küçükgüçlü Ö, Akyol MA. Does having a family member with dementia affect health beliefs about changing lifestyle and health behaviour for dementia risk reduction? Psychogeriatrics 2024. [PMID: 38811353 DOI: 10.1111/psyg.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Dementia is a worldwide public health concern. Implementing lifestyle changes that target modifiable risk factors is crucial for reducing the risk of dementia. The aim of this study was to investigate the effect of having family members with dementia on individuals' health beliefs and tendencies towards adopting healthier lifestyles and behaviours. METHODS A cross-sectional, comparative study was conducted with 338 people aged 40 years and older, of whom 168 have the experience of having family members with dementia, and 170 have no such experience. Data were collected using a characteristics form, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale, and the modified Charlson comorbidity index. Descriptive statistics, Pearson's chi-square and independent t-tests, were used. RESULTS Those with family members with dementia were more likely to have greater motivation to modify their lifestyle (perceived susceptibility, severity, benefits, and cues to action) to reduce their risk of developing dementia. Additionally, they had greater perceived barriers to gain by adopting a healthy lifestyle, in contrast to those without such family members. CONCLUSION The presence of family members with dementia could be an important factor to consider when designing initiatives targeting health beliefs related to dementia prevention behaviours and lifestyle changes.
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Affiliation(s)
- Melek Şener
- SBU Izmir Bozyaka Education and Research Hospital, Karabaglar, Turkiye
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Turkiye
| | - Merve Aliye Akyol
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Turkiye
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Dingle SE, Milte CM, Daly RM, Torres SJ. Attitudes and Considerations for Multidomain Lifestyle Approaches to Dementia Prevention: A Qualitative Study. J Alzheimers Dis 2024; 97:939-949. [PMID: 38160351 DOI: 10.3233/jad-230176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Dementia, with the most common form being Alzheimer's disease, is a global health issue and lifestyle-based strategies may reduce risk. Individuals with a family history of dementia are an important target group, but little is known about their attitudes and perceptions of dementia risk reduction. OBJECTIVE To elucidate the attitudes to and key considerations for multidomain lifestyle-based dementia prevention strategies in middle-aged Australians with a family history of dementia. METHODS Twenty participants (80% female; age range 47-65 years), undertook semi-structured phone-based interviews. Inductive thematic analysis of interview transcripts was conducted. Hierarchical coding frames and illustrative quotes were compiled and critically challenged until a final set of themes was produced. RESULTS Some participants expressed a positive attitude toward lifestyle-based dementia prevention. Reasons related to wanting to future proof, believing that risk reduction is relevant at all life stages and/or that there is always room for improvement. Other participants had a negative attitude, expressing that they were already following a healthy lifestyle, did not feel it was relevant to them yet, and/or held a deterministic view that dementia is random. Important considerations congregated on the themes of being tailored/personalized, taking a holistic approach, and involving small, achievable steps. CONCLUSIONS In individuals with a family history of dementia, a positive attitude to dementia prevention holds promise for intervention efforts, but in individuals expressing negative attitudes, further education and individual-level counselling may be warranted. Multidomain lifestyle-based preventive strategies also need to be tailored to the needs of key target groups to optimize appeal and effectiveness.
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Affiliation(s)
- Sara E Dingle
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Lin RSY, Su JJ, Kim S, Wong AKC, Chan TW, Lee SHC. Psychometric properties of the Chinese version of the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction scale (MCLHB-DRR) in Chinese community-dwelling older adults. Geriatr Nurs 2023; 54:237-245. [PMID: 37847938 DOI: 10.1016/j.gerinurse.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To assess the psychometric properties of Chinese version of Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR) scale in Chinese community-dwelling older adults. METHODS A convenience sample of 150 Chinese adults aged ≥50 was recruited from local community facilities. Reliability of MCLHB-DRR was evaluated using internal consistency and test-retest reliability over two weeks. Content validity and construct validity were assessed. Translation process followed Brislin's translation model. RESULTS After excluding two items with poor loadings, the confirmatory factor analysis revealed a good model fit (χ2/df=2.14; CFI=0.91; IFI=0.91; RMSEA=0.087). The scale exhibited good internal consistency (Cronbach's alpha = 0.865), as well as acceptable test-retest reliability (ICC=0.730). CONCLUSIONS The Chinese MCLHB-DRR showed satisfactory psychometric properties, providing valuable insights for promoting dementia risk reduction in Chinese population, considering cultural nuances that shape motivations and knowledge of lifestyle changes.
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Affiliation(s)
- Rose Sin Yi Lin
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, 255 Crittenden Blvd, Rochester, New York, 14620, USA
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Sarang Kim
- Australian Institute of Health and Welfare, 26 Thynne Street, Bruce, ACT, Australia
| | | | - Tsz Wing Chan
- Pamela Youde Nethersole Eastern Hospital, Main Block, Lok Man Rd, Chai Wan, Hong Kong
| | - Sonia Ho Ching Lee
- The Hong Kong Society for Rehabilitation, Units R9-R12, Podium, Wo Che Plaza, Wo Che Estate, Shatin, NT
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Wang W, Fang S, Zhang S, He M, Zhu X, Dong Y, Ma D, Zhao Y, Meng X, Zhang M, Sun J. Gaps in awareness and practice of healthy lifestyles among individuals at high risk of colorectal cancer: A qualitative evidence synthesis. J Clin Nurs 2023; 32:5737-5751. [PMID: 36967562 DOI: 10.1111/jocn.16696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/14/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
AIMS To systematically examine and review relevant qualitative studies exploring the current lifestyle among individuals at high risk of colorectal cancer (CRC), and their awareness of the role of a healthy lifestyle in CRC prevention. BACKGROUND The increasing incidence and mortality of CRC have presented a serious threat against the health and life of people. As the major population affected by CRC, the lifestyle of individuals at a high risk of CRC is attracting increasing attention. DESIGN A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. DATA SOURCES Literature was retrieved from PubMed, Web of Science, the Cochrane Library, Embase, CINAHL and PsycINFO from the inception to December 2021. REVIEW METHODS Two reviewers independently screened the titles and abstracts and identified the eligible studies. Critical appraisals of each included study were performed. Thematic analysis was used to guide the data synthesis. RESULTS The data from nine articles were analysed. Three interpretive themes were extracted that formed an overarching synthesis of the experience with healthy lifestyles among high-risk individuals of CRC. The findings suggested that these individuals with limited awareness of CRC and personal risks lacked sufficient knowledge about the relationship between lifestyle and CRC, and their attitudes and practices towards the role of a healthy lifestyle in CRC prevention were also diversified. CONCLUSION Professionals can potentially provide personalised guidance for healthy lifestyles based on knowledge of prevention, the actual background and social support of individuals at high risk of CRC. IMPACT Considering that knowledge gaps and health beliefs among these individuals are the premise blocking their adoption of a healthy lifestyle, the findings of this review may make contributions to the design and content of public health policy and prevention programs. No patient or public contribution.
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Affiliation(s)
- Wenxia Wang
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Shuyan Fang
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Shuang Zhang
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Meng He
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Xiangning Zhu
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Yueyang Dong
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Dongfei Ma
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Yanjie Zhao
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Xiangfei Meng
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Mengting Zhang
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Jiao Sun
- Basic Nursing Department, School of Nursing, Jilin University, Jilin, People's Republic of China
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Kjelvik G, Selbæk G, Rokstad AMM. Knowledge and motivation to adopt recommended health behaviours to reduce dementia risk among the elderly in Norway: a qualitative study. Public Health 2023; 221:60-65. [PMID: 37406451 DOI: 10.1016/j.puhe.2023.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES Dementia is a major healthcare challenge; however, there is evidence that modifiable risk factors may contribute to reduce dementia risk. The aim of the study was to explore the knowledge and motivation for adopting recommended health behaviours among older adults in Norway. STUDY DESIGN The study has a qualitative, descriptive design. METHODS Individual interviews were used for data collection. The study population comprised 15 participants, five men and 10 women, aged ≥73 years, recruited from a region in the centre of Norway. Interviews were analysed according to qualitative content analysis. RESULTS Three categories were identified and presented as the main findings, as follows: (1) sufficient knowledge about risk reduction for dementia, including the media as the main source of information; (2) current prevention activities and motivation for risk reduction, including physical, social and cognitive activities and a healthy diet; and (3) motivation for prevention of dementia from a life-course perspective, including experience of health problems, desire to live independently and limited awareness of dementia risk factors in midlife. CONCLUSIONS To tailor information about the modifiable risk factors of dementia and develop preventive interventions, knowledge about motivating factors is essential. Promotion of healthy ageing is required in addition to addressing the fear of future illness and dependency.
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Affiliation(s)
- G Kjelvik
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - G Selbæk
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - A M M Rokstad
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.
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McEvoy CT, Regan-Moriarty J, Dolan C, Bradshaw C, Mortland V, McCallion M, McCarthy G, Kennelly SP, Kelly J, Heffernan M, Kee F, McGuinness B, Passmore P. A qualitative study to inform adaptations to a brain health intervention for older adults with type 2 diabetes living in rural regions of Ireland. Diabet Med 2023; 40:e15034. [PMID: 36572988 DOI: 10.1111/dme.15034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/10/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
AIMS Type 2 diabetes is a risk factor for late-life dementia, but dementia prevention strategies have yet to be comprehensively evaluated in people with diabetes. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated cognitive benefits of a 2-year multidomain lifestyle intervention. However, given the intensive nature of FINGER, there is uncertainty about whether it can be implemented in other high-risk populations. Our aim was to explore attitudes towards dementia risk, and barriers to an intervention based on the FINGER model in older adults with type 2 diabetes living in rural areas of Ireland. METHODS Focus groups were conducted with 21 adults (11 men and 10 women) aged 60+ years with type 2 diabetes living in border regions of north and south Ireland. Data were analysed using thematic analysis. RESULTS There was limited understanding of diabetes as a risk factor for late-life dementia. The main barriers to engagement with the multidomain intervention were eating foods that were not compatible with cultural norms, time and travel constraints, and perceived lack of self-efficacy and self-motivation for adopting the desired diet, exercise and computerised cognitive training (CCT) behaviours. Facilitators for intervention acceptability included the provision of culturally tailored and personalised education, support from a trusted source, and inclusion of goal setting and self-monitoring behavioural strategies. CONCLUSIONS While there was high acceptability for a brain health intervention, several barriers including cultural food norms and low self-efficacy for adopting the diet, exercise and CCT components would need to be considered in the intervention design. Findings from this study will be used to inform local decisions regarding the adaptation of FINGER for people with type 2 diabetes. The feasibility of the adapted multidomain intervention will then be evaluated in a future pilot trial.
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Affiliation(s)
- Claire T McEvoy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Joanne Regan-Moriarty
- Department of Health and Nutritional Sciences, Atlantic Technological University, Sligo, Ireland
| | - Catherine Dolan
- Galway and Sligo Leitrim Mental Health Services, National University of Ireland, Sligo, Ireland
| | - Caroline Bradshaw
- Galway and Sligo Leitrim Mental Health Services, National University of Ireland, Sligo, Ireland
| | - Valerie Mortland
- Department of Geriatric Medicine, South West Acute Hospital, Enniskillen, UK
| | - Maire McCallion
- Department of Health and Nutritional Sciences, Atlantic Technological University, Sligo, Ireland
| | - Geraldine McCarthy
- Galway and Sligo Leitrim Mental Health Services, National University of Ireland, Sligo, Ireland
| | - Seán P Kennelly
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Jim Kelly
- Department of Geriatric Medicine, South West Acute Hospital, Enniskillen, UK
| | - Margaret Heffernan
- Galway and Sligo Leitrim Mental Health Services, National University of Ireland, Sligo, Ireland
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Peter Passmore
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Bruinsma J, Heger I, Loukas VS, Kassiotis T, Karanasiou G, Fotiadis DI, Hanke S, Crutzen R. Public Perspectives on Lifestyle-Related Behavior Change for Dementia Risk Reduction: An Exploratory Qualitative Study in The Netherlands. J Alzheimers Dis 2023; 95:1635-1642. [PMID: 37718799 PMCID: PMC10578282 DOI: 10.3233/jad-230217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND There is accumulating evidence that addressing modifiable risk and protective factors has an impact on dementia rates. Insight into the public's perspectives on dementia risk reduction is needed to inform future individual-level interventions and public health approaches. OBJECTIVE This study explores the publics' openness towards dementia risk reduction and willingness towards changing lifestyle behavior to reduce the future risk for dementia. METHODS Using a screening questionnaire, participants were purposively selected based on lifestyle behaviors that are associated with dementia risk. One-on-one interviews were used to explore their openness towards dementia risk reduction and willingness towards behavior change. Independently, two researchers performed an inductive content analysis. RESULTS Interviews were conducted with 23 participants aged from 40 to 79 years. Main themes that were identified from the data were: 1) abstractness of dementia risk reduction, 2) ambivalence towards changing behavior, 3) negative self-image and low behavioral control, and 4) all-or-nothing thinking about lifestyle change. CONCLUSIONS The concept of dementia risk reduction seems difficult to translate to the personal context, particularly if individuals perceive that dementia would occur decades in the future. This is problematic because a large proportion of the public needs a healthier lifestyle to reduce the incidence of dementia. Translating healthy intentions into behavior is complex and involves overcoming a variety of barriers that complicate dementia risk reduction initiatives. Support is needed for individuals who experience additional obstacles that obstruct commencing to a healthier lifestyle (e.g., negative self-image, engaging in multiple unhealthy behaviors, unrealistic perceptions about lifestyle change).
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Affiliation(s)
- Jeroen Bruinsma
- Department of Health Promotion of the Care and Public Health Research Institute at Maastricht University, Maastricht, The Netherlands
| | - Irene Heger
- Department of Psychiatry and Neuropsychology of the School for Mental Health and Neuroscience at Maastricht University, Maastricht, The Netherlands
| | - Vasileios S. Loukas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology - Hellas, FORTH-BRI, Ioannina, Greece
| | - Thomas Kassiotis
- Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology – Hellas, FORTH-ICS-CBML, Heraklion, Crete, Greece
| | - Georgia Karanasiou
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology - Hellas, FORTH-BRI, Ioannina, Greece
| | - Dimitrios I. Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology - Hellas, FORTH-BRI, Ioannina, Greece
| | - Sten Hanke
- Institute of eHealth at University of Applied Science at FH Joanneum, Graz, Austria
| | - Rik Crutzen
- Department of Health Promotion of the Care and Public Health Research Institute at Maastricht University, Maastricht, The Netherlands
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Li H, Zhang J, Wang L, Yang T, Yang Y. A health promoting-lifestyle prediction model for dementia prevention among chinese adults: based on the health belief model. BMC Public Health 2022; 22:2450. [PMID: 36577998 PMCID: PMC9798682 DOI: 10.1186/s12889-022-14828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/07/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND People's health belief is an important factor affecting health behavior. However, there has been little use of the health belief model (HBM) in determining the pathway effect of patients' beliefs on health behavior in dementia prevention in China. The aim of our study was to evaluate the impact of dementia prevention beliefs on health promoting lifestyle among Chinese adults. METHODS A cross-sectional study was conducted on line by convenience sampling from January to March 2020. A survey about dementia prevention knowledge, health belief of dementia prevention and health-promoting lifestyle was completed by 1201 adults in China. Data was analyzed using a structural equation model with the analysis of moment program. RESULTS The participants were aged 40.50 ± 12.72 years. About 70.3% of participants were female. The purposed model fit the data from the study well. Perceived barriers (total effect-0.322, P < 0.01) and perceived susceptibility (total effect -0.242, P < 0.01) had negative effects on lifestyle. Self-efficacy had promoting effects on lifestyle (total effect 0.207, P < 0.01). Perceived severity had positive effects both on perceived benefits (total effect 0.137, P < 0.01) and perceived barriers (total effect 0.202, P < 0.01), which had a contradictory effect in the formation of health belief. Perceived benefits, cues to action and self-efficacy played a partial mediating role between knowledge and health behavior. The belief of changing lifestyle to reduce the risk of dementia could explain 24.5% of health behavior (P < 0.05). CONCLUSIONS The findings indicate that in dementia prevention, dementia prevention health belief has important influences on health behavior. Community medical staff can develop targeted dementia prevention interventions based on the health belief model in the future.
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Affiliation(s)
- Hua Li
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China ,Department of Otolaryngology Head and Neck Surgery, The 940th Hospital of Joint Logistics Support force of Chinese People’s Liberation Army, Lanzhou, China
| | - Jinying Zhang
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China
| | - Li Wang
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China
| | - Tiantian Yang
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China
| | - Yanni Yang
- School of Nursing, Army Medical University, Chongqing, China.
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Nasreddine Z, Garibotto V, Kyaga S, Padovani A. The Early Diagnosis of Alzheimer's Disease: A Patient-Centred Conversation with the Care Team. Neurol Ther 2022; 12:11-23. [PMID: 36528836 PMCID: PMC9837364 DOI: 10.1007/s40120-022-00428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder which accounts for 60-80% of dementia cases, affecting approximately 10 million people in Europe. Neuroimaging techniques and cerebrospinal fluid biomarkers used in combination with cognitive assessment tools open the door to early diagnosis of AD. However, these tools present some challenges that need to be overcome, such as low sensitivity or specificity, high cost, limited availability or invasiveness. Thus, low-cost and non-invasive alternatives, such as plasma biomarkers, have the potential to drive changes in AD screening and diagnosis. In addition to the technical aspects, organisational challenges as well as ethical concerns need to be addressed. In many countries, there is an insufficient number of specialists to recognise, evaluate and diagnose dementia and the waiting times to see a specialist are long. Given that there is currently no cure for AD, it is important to consider the potential psychological impact of an early diagnosis. In addition, counselling before biomarker sampling and during diagnosis disclosure is vital to guarantee that the patients have all the information necessary and their queries are addressed in a sensitive manner. Here, we illustrate (using a clinical vignette) current challenges of diagnosis and discuss some of the benefits and challenges of early diagnosis in AD including the value of biomarkers in combination with clinical evaluation. Lastly, some guidelines for disclosing early diagnosis of AD are provided based on our experiences.
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Affiliation(s)
| | - Valentina Garibotto
- grid.150338.c0000 0001 0721 9812University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Simon Kyaga
- Biogen International GmbH, Neuhofstrasse 30, 6340, Baar, Switzerland.
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Pacifico D, Fiordelli M, Fadda M, Serena S, Piumatti G, Carlevaro F, Magno F, Franscella G, Albanese E. Dementia is (not) a natural part of ageing: a cross-sectional study on dementia knowledge and misconceptions in Swiss and Italian young adults, adults, and older adults. BMC Public Health 2022; 22:2176. [PMID: 36434540 PMCID: PMC9701025 DOI: 10.1186/s12889-022-14578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Increasing public awareness and understanding of dementia is the second key action area of the 2017 WHO Global action plan on a public health response to dementia. To achieve this aim, the first indispensable step is to understand the average level of dementia knowledge and to identify areas of low dementia knowledge. We aimed to quantify dementia knowledge in the general population, and to explore the extent to which it differs by age, sex, education, and indirect experience with dementia. METHODS We conducted an online cross-sectional survey in two Italian-speaking sites, south Switzerland (Ticino) and northern Italy (Piedmont). The survey was distributed between September and December 2019. We registered socio-demographic characteristics including whether the participant had contact with a person living with dementia, and measured dementia knowledge with the Dementia Knowledge Assessment Survey (DKAS). RESULTS Misconceptions about dementia were common among respondents, and lack of knowledge has been identified in dementia causes, characteristics, risk factors, and health promotion. Our results point out the lack of knowledge about how to communicate and relate with, and take care of a person living with dementia. The overall DKAS score was significantly and positively associated with female sex (β = 0.21; p < 0.001), educational level (β = 0.15; p < 0.001) and contact with a person living with dementia (β = 0.17; p < 0.001), but not with age (β = -0.01; p = 0.57). CONCLUSION Our results confirmed that general population's knowledge of dementia is thin. Interventional studies that rely on participatory action research methods are warranted to co-design interventions aimed at improving dementia knowledge and understanding in the public.
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Affiliation(s)
- Deborah Pacifico
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Marta Fadda
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Sabatini Serena
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | | | - Fabio Carlevaro
- grid.7605.40000 0001 2336 6580Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Turin, Italy
| | - Francesca Magno
- grid.7605.40000 0001 2336 6580Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Turin, Italy ,grid.7605.40000 0001 2336 6580University of Turin, Turin, Italy
| | - Giovanni Franscella
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland ,grid.8591.50000 0001 2322 4988Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Oliveira D, Knight H, Jones KA, Ogollah R, Orrell M. Motivation and willingness to increase physical activity for dementia risk reduction: Cross-Sectional UK survey with people aged 50 and over. Aging Ment Health 2022; 26:1899-1908. [PMID: 34607490 DOI: 10.1080/13607863.2021.1984393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
METHODS Attitudes to increasing physical activity to reduce risk of dementia were assessed in a national online survey promoted via online forums and public adverts. The Motivation to Change Behaviour for Dementia Risk Reduction (MOCHAD-10) scale examined motivation for lifestyle change. Multivariable logistic regression was used to identify the predictors of willingness and motivation to increase physical activity. RESULTS Data from 3,948 individuals showed most people were moderately/very physically active (80%). People more likely to be physically active had better health and education, were older, male, and had a partner. People willing to increase physical activity (73%) were more likely to be younger, non-White, underweight, had better health and lifestyles, and had experience caring for someone with dementia. People with higher levels of motivation to change lifestyle (MOCHAD-10 subscales) were more likely to be female, younger, in poorer physical/mental health, had lower perceived mental activity, and were a carer for someone with dementia. CONCLUSION Men and those with better health status were more physically active. Those who exercised less and those who were more motivated to increase physical activity were not necessarily able to be physically active. Multisectoral public health strategies should seek to use the high motivation levels among this group to mitigate the barriers related to physical activity for dementia risk reduction.
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Affiliation(s)
- Déborah Oliveira
- Department of Psychiatry, School of Medicine, Universidade Federal de Sao Paulo (UNIFESP), São Paulo, Brazil.,Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Holly Knight
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katy A Jones
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Reuben Ogollah
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Martin Orrell
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
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12
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Farrow M, Fair H, Klekociuk SZ, Vickers JC. Educating the masses to address a global public health priority: The Preventing Dementia Massive Open Online Course (MOOC). PLoS One 2022; 17:e0267205. [PMID: 35507576 PMCID: PMC9067672 DOI: 10.1371/journal.pone.0267205] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/04/2022] [Indexed: 02/03/2023] Open
Abstract
Dementia is a global public health priority and risk reduction is an important pillar of the public health response. While 40% of cases are estimated to be attributable to modifiable health and lifestyle risk factors, public awareness of the evidence is low, limiting peoples’ opportunity to adopt risk-reducing behaviours. To address this gap, we designed, implemented, and evaluated an educational intervention, the Preventing Dementia Massive Open Online Course (PDMOOC). This mixed-methods study examined the reach and impact of the free and globally available PDMOOC, to assess its potential to provide effective dementia risk reduction education to a broad international audience. Over 100,000 individuals participated in the PDMOOC across seven iterations from 2016 to 2020, with 55,739 of these consenting to participate in research. Their mean age was 49 years (SD = 15), they came from 167 different countries, and the majority were female (86%), had completed post-secondary education (77%), lived in high-income countries (93%) and worked in health care and social assistance (63%). This demographic profile changed across time, with more men, people with higher education and people from low- and middle-income countries participating in recent course iterations. Two-thirds of participants completed the PDMOOC; completion was associated with being aged 50 to 70 years, residing in a high-income country, having tertiary education, and working in the health sector. Participants reported high levels of satisfaction with the PDMOOC, improved dementia risk reduction understanding and self-efficacy, increased motivation to maintain healthy lifestyles, and, importantly, application of their learning to health behaviour change with the potential to reduce their dementia risk. The PDMOOC educated a large global audience about dementia risk reduction, which contributed to participants making risk-reducing behaviour changes. This suggests MOOCs can be a successful public health strategy to improve dementia risk reduction understanding.
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Affiliation(s)
- Maree Farrow
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
- * E-mail:
| | - Hannah Fair
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Shannon Z. Klekociuk
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - James C. Vickers
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Budin-Ljøsne I, Mowinckel AM, Friedman BB, Ebmeier KP, Drevon CA, Carver RB, Zsoldos E, Fredheim NAG, Sørensen Ø, Baaré WFC, Madsen KS, Fjell AM, Kievit RA, Ghisletta P, Bartrés-Faz D, Nawijn L, Solé-Padullés C, Walhovd KB, Düzel S, Zasyekina L, Iulita MF, Ferretti MT. Public perceptions of brain health: an international, online cross-sectional survey. BMJ Open 2022; 12:e057999. [PMID: 35437254 PMCID: PMC9016409 DOI: 10.1136/bmjopen-2021-057999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To investigate public perspectives on brain health. DESIGN Cross-sectional multilanguage online survey. SETTING Lifebrain posted the survey on its website and social media and shared it with stakeholders. The survey was open from 4 June 2019 to 31 August 2020. PARTICIPANTS n=27 590 aged ≥18 years from 81 countries in five continents completed the survey. The respondents were predominantly women (71%), middle aged (41-60 years; 37%) or above (>60 years; 46%), highly educated (69%) and resided in Europe (98%). MAIN OUTCOME MEASURES Respondents' views were assessed regarding factors that may influence brain health, life periods considered important to look after the brain and diseases and disorders associated with the brain. We run exploratory linear models at a 99% level of significance to assess correlates of the outcome variables, adjusting for likely confounders in a targeted fashion. RESULTS Of all significant effects, the respondents recognised the impact of lifestyle factors on brain health but had relatively less awareness of the role socioeconomic factors might play. Most respondents rated all life periods as important for the brain (95%-96%), although the prenatal period was ranked significantly lower (84%). Equally, women and highly educated respondents more often rated factors and life periods to be important for brain health. Ninety-nine per cent of respondents associated Alzheimer's disease and dementia with the brain. The respondents made a connection between mental health and the brain, and mental disorders such as schizophrenia and depression were significantly more often considered to be associated with the brain than neurological disorders such as stroke and Parkinson's disease. Few respondents (<32%) associated cancer, hypertension, diabetes and arthritis with the brain. CONCLUSIONS Differences in perceptions of brain health were noted among specific segments of the population. Policies providing information about brain-friendly health behaviours and targeting people less likely to have relevant experience may be needed.
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Affiliation(s)
| | - Athanasia Monika Mowinckel
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Barbara Bodorkos Friedman
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | | | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Vitas AS, Oslo, Norway
| | - Rebecca Bruu Carver
- Department of Communication, Norwegian Institute of Public Health, Oslo, Norway
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford, UK
| | | | - Øystein Sørensen
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - William Frans Christiaan Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, København, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, København, Denmark
| | - Anders M Fjell
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Rogier A Kievit
- Cognitive Neuroscience Department, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES, Geneva, Switzerland
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cristina Solé-Padullés
- Department of Medicine, Faculty of Medicine and Health Sciences and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Kristine B Walhovd
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Sandra Düzel
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Larisa Zasyekina
- Department of General and Clinical Psychology, Lesya Ukrainka Volyn National University, Luc'k, Ukraine
| | - Maria Florencia Iulita
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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14
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Ha EH. Home-dwelling older adults' attitudes and perceptions of dementia: A Q-methodological study in South Korea. Jpn J Nurs Sci 2022; 19:e12467. [PMID: 34981635 DOI: 10.1111/jjns.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
AIM Older adult attitudes and perceptions of dementia can have a major impact on early diagnosis, efforts to prevent and appropriately treat it, as well as being a family burden. The aim of this study is to explore attitudes and perceptions of dementia of home-dwelling older adults using Q-methodology. METHOD A total of 42 adults, age 65 or over, who live in South Korea ranked 37 Q statements about their attitudes and perceptions of dementia into A Q sort table grid. RESULTS The following three distinct viewpoints were extracted: (1) it is my responsibility to prevent and to care about dementia (family-centered view); (2) there are no ways to treat dementia (despairing views); and (3) dementia is a national responsibility (nation-centered view). CONCLUSION Based on these results, central and local government and communities should work together with older adults to manage dementia and reflect these three viewpoints when developing systematic dementia management programs.
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Affiliation(s)
- Eun-Ho Ha
- Department of Nursing, Jungwon University, Goesan-gun, South Korea
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15
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Akenine U, Thunborg C, Kivipelto M, Fallahpour M. Experiences of Participation in a Multimodal Preventive Trial MIND-ADMINI Among Persons with Prodromal Alzheimer’s Disease: A Qualitative Study. J Multidiscip Healthc 2022; 15:219-234. [PMID: 35125872 PMCID: PMC8811792 DOI: 10.2147/jmdh.s345607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Alzheimer’s disease (AD) is one of the world’s leading public health challenges. One-third of AD cases are attributable to modifiable vascular and lifestyle-related risk factors. The Multimodal Preventive Trial for Alzheimer’s Disease, MIND-ADMINI a 6-month multinational parallel-group randomized controlled trial (RCT), targeted persons with prodromal AD and built on the positive outcomes from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial. The intervention consisted of four main components of (i) physical exercise training program, (ii) nutrition guidance, (iii) cognitive training, and (iv) social stimulation, as well as (iv) monitoring of metabolic/vascular risk factors. Aim The study aimed to explore and describe the experiences of participation in MIND-ADMINI among persons with prodromal AD. Methods This qualitative study was part of the larger MIND-ADMINI project. Eight participants were interviewed twice, before and after the intervention. The data was analyzed using qualitative content analysis. Results The results are presented as categories of (i) knowledge of AD and prevention, (ii) motives for study participation, (iii) experiences of the received information about the study, (iv) taking the decision to participate, (v) expectations on study participation, (vi) experiences of study participation and (vii) internal and external factors influencing study participation. Conclusion The MIND-ADMINI was well-tolerated by the participants. At the beginning of the study, the number of tasks and visits was perceived as burdensome but was later well-tolerated. The participant’ knowledge about AD and prevention increased during the trial. Their motives for participating in MIND-ADMINI were described as both altruistic and self-beneficial. Health benefits from the study components, access to specialized medical care were identified as benefits. Managing the intensive flow of information was described a major challenge. The participants’ needs for personalized support during the trial stress the importance of applying a person-centered approach providing the preventive trials.
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Affiliation(s)
- Ulrika Akenine
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Correspondence: Ulrika Akenine Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska vägen 37A, QA32, SE-171 64, Solna, Stockholm, SwedenTel +46 70 667 99 67 Email
| | - Charlotta Thunborg
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- School of Health, Care and Social Welfare, Department of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Miia Kivipelto
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- School of Health, Care and Social Welfare, Department of Physiotherapy, Mälardalen University, Västerås, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
| | - Mandana Fallahpour
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
- Mandana Fallahpour Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Alfred Nobels Allé 23, SE-141 83 Huddinge, Stockholm, SwedenTel +46 8 524 838 56 Email
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16
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Smith E, Ibanez A, Lavretsky H, Berk M, Eyre HA. Psychographic Segmentation: Another Lever for Precision Population Brain Health. Front Aging Neurosci 2021; 13:783297. [PMID: 34955814 PMCID: PMC8692771 DOI: 10.3389/fnagi.2021.783297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
Dementia prevention interventions that address modifiable risk factors for dementia require extensive lifestyle and behavior changes. Strategies are needed to enhance engagement and personalization of the experience at a population level. Precision Population Brain Health aims to improve brain health across the lifespan at a population level. Psychographic segmentation is a core component of Precision Population Brain Health with untapped potential. Psychographic segmentation applies behavioral and social sciences to understanding people's motivations, values, priorities, decision making, lifestyles, personalities, communication preferences, attitudes, and beliefs. Integrating psychographic segmentation into dementia care could provide a more personalized care experience and increased patient engagement, leading to improved health outcomes and reduced costs. Psychographic segmentation can enhance patient engagement for dementia and shift the clinical paradigm from "What is the matter?" to "What matters to you?" Similar benefits of psychographic segmentation can be provided for dementia caregivers. Developing dementia prevention programs that integrate psychographic segmentation could become the basis for creating a shared framework for prevention of non-communicable diseases and brain health disorders at a population level. Integrating psychographic segmentation into digital health tools for dementia prevention programs is especially critical to overcome current suboptimal approaches. Applying psychographic segmentation to dementia prevention has the potential to help people feel a sense of empowerment over their health and improve satisfaction with their health experience-creating a culture shift in the way brain health is approached and paving the way toward Precision Population Brain Health.
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Affiliation(s)
- Erin Smith
- Neuroscience-Inspired Policy Initiative, Organization for Economic Co-operation and Development (OECD) and the PRODEO Institute, Paris, France.,Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, CA, United States.,Trinity College Dublin, Dublin, Ireland.,Department of Medicine, Stanford Hospital, Stanford, CA, United States.,The PRODEO Institute, San Francisco, CA, United States
| | - Agustin Ibanez
- Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, CA, United States.,Trinity College Dublin, Dublin, Ireland.,Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.,Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Orygen Youth Health, University of Melbourne, Melbourne, VIC, Australia.,The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Harris A Eyre
- Neuroscience-Inspired Policy Initiative, Organization for Economic Co-operation and Development (OECD) and the PRODEO Institute, Paris, France.,Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, CA, United States.,Trinity College Dublin, Dublin, Ireland.,The PRODEO Institute, San Francisco, CA, United States.,The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
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17
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Kouzuki M, Furukawa S, Mitani K, Urakami K. Examination of the cognitive function of Japanese community-dwelling older adults in a class for preventing cognitive decline during the COVID-19 pandemic. PLoS One 2021; 16:e0248446. [PMID: 34898633 PMCID: PMC8668118 DOI: 10.1371/journal.pone.0248446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/28/2021] [Indexed: 11/18/2022] Open
Abstract
We examined the changes in cognitive function due to restrictions in daily life during the coronavirus disease 2019 (COVID-19) pandemic in community-dwelling older adults with mild cognitive decline. This was a retrospective, case-control study. The participants include 88 older adults with mild cognitive decline (mean age = 81.0 [standard deviation = 6.5] years) who participated in a class designed to help prevent cognitive decline. This class was suspended from early-March to end of May 2020 to prevent the spread of COVID-19, and resumed in June 2020. We collected demographic and cognitive function test data (Touch Panel-type Dementia Assessment Scale [TDAS]) before and after class suspension and questionnaire data on their lifestyle and thoughts during the suspension. Change in TDAS scores from before and after the suspension was used to divide the participants into decline (2 or more points worsening) and non-decline (all other participants) groups, with 16 (18.2%) and 72 (81.8%) participants in each group, respectively. A logistic regression model showed that the odds ratio (OR) for cognitive decline was lower in participants whose responses were “engaged in hobbies” (OR = 0.07, p = 0.015), “worked on a worksheet about cognitive training provided by the town hall” (OR = 0.19, p = 0.026), and “had conversations over the phone” (OR = 0.28, p = 0.0495). There was a significant improvement in TDAS scores after class was resumed (p < 0.01). A proactive approach to intellectual activities and social ties may be important for the prevention of cognitive decline during periods of restrictions due to COVID-19. We found that cognitive function test scores before class suspension significantly improved after resuming classes. We speculate that continued participation in this class led to positive behavioral changes in daily life during periods of restriction due to COVID-19.
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Affiliation(s)
- Minoru Kouzuki
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
- * E-mail:
| | - Shota Furukawa
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Keisuke Mitani
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Katsuya Urakami
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
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18
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Keage HAD, Villani G, Hutchinson AD. What do young Australian adults know about modifiable risk factors for dementia? BMC Public Health 2021; 21:2166. [PMID: 34823503 PMCID: PMC8616573 DOI: 10.1186/s12889-021-12220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are well established modifiable risk factors for late-life dementia. These risk factors account for over 30% of population attributable dementia risk and accrue over the lifespan. Young adults have the greatest potential to reduce their own risk for dementia. This study aimed to investigate what young Australian adults know about dementia and its risk factors, and further, how they estimated these risks. METHODS An online survey promoted through various social media platforms was completed by 604 young Australian adults aged 18-44 years of age. RESULTS Seventy percent of participants had a limited understanding of dementia (identifying cognitive or functional impairment), 25% had a good understanding, with 5% having no understanding. Twenty percent of respondents thought there were no modifiable risk factors for dementia. Less the half of participants agreed with two of the nine established dementia risk factors (hearing loss in midlife and education in early life), with over half of participants agreeing to the remaining seven risk factors. Females consistently judged the risks conferred by the nine established dementia risk factors to be higher than males. Those who were lonely judged the dementia risk conferred by loneliness to be higher than those who were not lonely; and smokers judged the dementia risk conferred by smoking to be less than non-smokers. CONCLUSION Young adults have the greatest potential to change their dementia risk, and these findings show that there are important gaps in knowledge of dementia and its risk factors in this group.
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Affiliation(s)
- Hannah A D Keage
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, South Australia, 5000, Australia.
| | - Gabrielle Villani
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, South Australia, 5000, Australia
| | - Amanda D Hutchinson
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, South Australia, 5000, Australia
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19
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Solomon A, Stephen R, Altomare D, Carrera E, Frisoni GB, Kulmala J, Molinuevo JL, Nilsson P, Ngandu T, Ribaldi F, Vellas B, Scheltens P, Kivipelto M. Multidomain interventions: state-of-the-art and future directions for protocols to implement precision dementia risk reduction. A user manual for Brain Health Services-part 4 of 6. Alzheimers Res Ther 2021; 13:171. [PMID: 34635167 PMCID: PMC8507202 DOI: 10.1186/s13195-021-00875-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/06/2021] [Indexed: 11/28/2022]
Abstract
Although prevention of dementia and late-life cognitive decline is a major public health priority, there are currently no generally established prevention strategies or operational models for implementing such strategies into practice. This article is a narrative review of available evidence from multidomain dementia prevention trials targeting several risk factors and disease mechanisms simultaneously, in individuals without dementia at baseline. Based on the findings, we formulate recommendations for implementing precision risk reduction strategies into new services called Brain Health Services. A literature search was conducted using medical databases (MEDLINE via PubMed and SCOPUS) to select relevant studies: non-pharmacological multidomain interventions (i.e., combining two or more intervention domains), target population including individuals without dementia, and primary outcomes including cognitive/functional performance changes and/or incident cognitive impairment or dementia. Further literature searches covered the following topics: sub-group analyses assessing potential modifiers for the intervention effect on cognition in the multidomain prevention trials, dementia risk scores used as surrogate outcomes in multidomain prevention trials, dementia risk scores in relation to brain pathology markers, and cardiovascular risk scores in relation to dementia. Multidomain intervention studies conducted so far appear to have mixed results and substantial variability in target populations, format and intensity of interventions, choice of control conditions, and outcome measures. Most trials were conducted in high-income countries. The differences in design between the larger, longer-term trials that met vs. did not meet their primary outcomes suggest that multidomain intervention effectiveness may be dependent on a precision prevention approach, i.e., successfully identifying the at-risk groups who are most likely to benefit. One such successful trial has already developed an operational model for implementing the intervention into practice. Evidence on the efficacy of risk reduction interventions is promising, but not yet conclusive. More long-term multidomain randomized controlled trials are needed to fill the current evidence gaps, especially concerning low- and middle-income countries and integration of dementia prevention with existing cerebrovascular prevention programs. A precision risk reduction approach may be most effective for dementia prevention. Such an approach could be implemented in Brain Health Services.
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Affiliation(s)
- Alina Solomon
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden.
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
| | - Ruth Stephen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuel Carrera
- Stroke Center, Department of Neurology, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Jenni Kulmala
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Peter Nilsson
- Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Tiia Ngandu
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Bruno Vellas
- Gérontopole of Toulouse, University Hospital of Toulouse (CHU-Toulouse), Toulouse, France
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Miia Kivipelto
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Beishon L, Haunton V, Subramaniam H, Mukaetova-Ladinska EB, Panerai RB, Robinson T, Evley R. Qualitative Analysis of the Cognition and Flow (CoGFlowS) Study: An Individualized Approach to Cognitive Training for Dementia Is Needed. J Alzheimers Dis 2021; 83:209-225. [PMID: 34250940 DOI: 10.3233/jad-210428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive training (CT) may have benefits for both healthy older adults (HC) and those with early cognitive disorders [mild cognitive impairment (MCI) and dementia]. However, few studies have qualitatively evaluated home-based, computerized CT programs. OBJECTIVE We present the qualitative arm of a feasibility randomized controlled trial evaluating a CT program for HC and people living with MCI or dementia. METHODS Participants underwent semi-structured interviews after 12 weeks of CT. Where possible, participants were interviewed with their carers. The interview schedule and analysis were underpinned by the health belief model. Interviews were audio-recorded, transcribed, open-coded, and categorized into themes. The analytical framework was developed, and themes were condensed under five major categories: benefits, barriers, threat, self-efficacy, and cues to action. RESULTS 37 participants underwent interviews. CT was feasible and acceptable to participants. Benefits included: enjoyment, improved awareness, benchmarking cognitive function, reassurance of abilities and giving back control. Barriers were more prevalent among those with dementia: problems with technology, frustration, conflict between patients and carers, apathy and lack of insight, anxiety or low mood, and lack of portability. HC and MCI perceived the severity of dementia risk as high, partially mitigated by CT. Participants living with dementia valued a more individualized approach to training, accounting for baseline characteristics. CONCLUSION CT was a feasible intervention for HC and people living with dementia and MCI. Benefits were present, but the identified barriers need to be addressed for CT to be implemented successfully.
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Affiliation(s)
- Lucy Beishon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Victoria Haunton
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Hari Subramaniam
- The Evington Centre, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Elizabeta B Mukaetova-Ladinska
- The Evington Centre, Leicestershire Partnership NHS Trust, Leicester, UK.,Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Thompson Robinson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Rachel Evley
- Inflammatory, Injury & Recovery Science, School of Medicine, University of Nottingham, Nottingham, UK
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21
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Essery R, Pollet S, Smith KA, Mowbray F, Slodkowska-Barabasz J, Denison-Day J, Hayter V, Bradbury K, Grey E, Western MJ, Milton A, Hunter C, Ferrey AE, Müller AM, Stuart B, Mutrie N, Griffin S, Kendrick T, Brooker H, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Planning and optimising a digital intervention to protect older adults' cognitive health. Pilot Feasibility Stud 2021; 7:158. [PMID: 34407886 PMCID: PMC8371874 DOI: 10.1186/s40814-021-00884-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of 'Active Brains': a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults. METHODS During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional 'guiding principles' and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content. RESULTS Scoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users. CONCLUSIONS A digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.
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Affiliation(s)
- Rosie Essery
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.
| | - Sebastien Pollet
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Kirsten A Smith
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Joanna Slodkowska-Barabasz
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - James Denison-Day
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Victoria Hayter
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | | | | | - Alexander Milton
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Cheryl Hunter
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Anne E Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.,Centre for Sport & Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Beth Stuart
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Simon Griffin
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tony Kendrick
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Bernard Gudgin
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Rosemary Phillips
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Tom Stokes
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - John Niven
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Paul Little
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK. .,School of Psychological Science, University of Bristol, Bristol, UK.
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22
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Korthauer LE, Denby C, Molina D, Wanjiku J, Daiello LA, Drake JD, Grill JD, Ott BR. Pilot study of an Alzheimer's disease risk assessment program in a primary care setting. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12157. [PMID: 33665347 PMCID: PMC7896638 DOI: 10.1002/dad2.12157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/15/2020] [Accepted: 12/29/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The goal of this study was to pilot a referral-based cognitive screening and genetic testing program for Alzheimer's disease (AD) risk assessment in a primary care setting. METHODS Primary care providers (PCPs; N = 6) referred patients (N = 94; M = 63 years) to the Rhode Island Alzheimer's Disease Prevention Registry for apolipoprotein E (APOE) genotyping and cognitive screening. PCPs disclosed test results to patients and counseled them about risk factor modification. RESULTS Compared to the Registry as a whole, participants were younger, more likely to be non-White, and had lower cognitive screening scores. Mild cognitive impairment participants correctly reported a higher perceived risk of developing AD. Patients who recalled being counseled about modifiable risk factors were more likely to report positive health behavior changes. DISCUSSION A referral-based program for cognitive and genetic AD risk assessment in a primary care setting is feasible, acceptable to patients, and yielded a more demographically diverse sample than an AD prevention registry.
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Affiliation(s)
- Laura E. Korthauer
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Charles Denby
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - David Molina
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Janet Wanjiku
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Lori A. Daiello
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Jonathan D. Drake
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Josh D. Grill
- Institute of Memory Impairments and Neurological DisordersDepartment of Psychiatry and Human BehaviorDepartment of Neurobiology and BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Brian R. Ott
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
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23
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Mai Y, Yu Q, Zhu F, Luo Y, Liao W, Zhao L, Xu C, Fang W, Ruan Y, Cao Z, Lei M, Au L, Mok VCT, Shi L, Liu J. AD Resemblance Atrophy Index as a Diagnostic Biomarker for Alzheimer's Disease: A Retrospective Clinical and Biological Validation. J Alzheimers Dis 2021; 79:1023-1032. [PMID: 33459705 DOI: 10.3233/jad-201033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) provides objective information about brain structural atrophy in patients with Alzheimer's disease (AD). This multi-structural atrophic information, when integrated as a single differential index, has the potential to further elevate the accuracy of AD identification from normal control (NC) compared to the conventional structure volumetric index. OBJECTIVE We herein investigated the performance of such an MRI-derived AD index, AD-Resemblance Atrophy Index (AD-RAI), as a neuroimaging biomarker in clinical scenario. METHOD Fifty AD patients (19 with the Amyloid, Tau, Neurodegeneration (ATN) results assessed in cerebrospinal fluid) and 50 age- and gender-matched NC (19 with ATN results assessed using positron emission tomography) were recruited in this study. MRI-based imaging biomarkers, i.e., AD-RAI, were quantified using AccuBrain®. The accuracy, sensitivity, specificity, and area under the ROC curve (AUC) of these MRI-based imaging biomarkers were evaluated with the diagnosis result according to clinical criteria for all subjects and ATN biological markers for the subgroup. RESULTS In the whole groups of AD and NC subjects, the accuracy of AD-RAI was 91%, sensitivity and specificity were 88% and 96%, respectively, and the AUC was 92%. In the subgroup of 19 AD and 19 NC with ATN results, AD-RAI results matched completely with ATN classification. AD-RAI outperforms the volume of any single brain structure measured. CONCLUSION The finding supports the hypothesis that MRI-derived composite AD-RAI is a more accurate imaging biomarker than individual brain structure volumetry in the identification of AD from NC in the clinical scenario.
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Affiliation(s)
- Yingren Mai
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qun Yu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
| | - Wang Liao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Zhao
- BrainNow Research Institute, Shenzhen, China
| | - Chunyan Xu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Wenli Fang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuting Ruan
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhiyu Cao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ming Lei
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lisa Au
- Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Vincent C T Mok
- BrainNow Research Institute, Shenzhen, China.,Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, China.,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Laboratory of RNA and Major Diseases of Brain and Heart, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
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24
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Vrijsen J, Abu-Hanna A, Maeckelberghe EL, De Deyn PP, de Winter AF, Reesink FE, Oude Voshaar RC, Buskens E, de Rooij SE, Smidt N. Uptake and effectiveness of a tailor-made online lifestyle programme targeting modifiable risk factors for dementia among middle-aged descendants of people with recently diagnosed dementia: study protocol of a cluster randomised controlled trial (Demin study). BMJ Open 2020; 10:e039439. [PMID: 33067294 PMCID: PMC7569992 DOI: 10.1136/bmjopen-2020-039439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Descendants of patients with dementia have a higher risk to develop dementia. This study aims to investigate the uptake and effectiveness of an online tailor-made lifestyle programme for dementia risk reduction (DRR) among middle-aged descendants of people with recently diagnosed late-onset dementia. METHODS AND ANALYSIS Demin is a cluster randomised controlled trial, aiming to include 21 memory clinics of which 13 will be randomly allocated to the passive (poster and flyer in a waiting room) and 8 to the active recruitment strategy (additional personal invitation by members of the team of the memory clinic). We aim to recruit 378 participants (40-60 years) with a parent who is recently diagnosed with Alzheimer's disease or vascular dementia at one of the participating memory clinics. All participants receive a dementia risk assessment (online questionnaire, physical examination and blood sample) and subsequently an online tailor-made lifestyle advice regarding protective (Mediterranean diet, low/moderate alcohol consumption and high cognitive activity) and risk factors (physical inactivity, smoking, loneliness, cardiovascular diseases (CVD), hypertension, high cholesterol, diabetes, obesity, renal dysfunction and depression) for dementia. The primary outcome is the difference in uptake between the two recruitment strategies. Secondary outcomes are change(s) in (1) the Lifestyle for Brain Health score, (2) individual health behaviours, (3) health beliefs and attitudes towards DRR and (4) compliance to the tailor-made lifestyle advice. Outcomes will be measured at 3, 6, 9 and 12 months after baseline. The effectiveness of this online tailor-made lifestyle programme will be evaluated by comparing Demin participants to a matched control group (lifelines cohort). ETHICS AND DISSEMINATION This study has been approved by the Dutch Ministry of Health, Welfare and Sport according to the Population Screening Act. All participants have to give online informed consent using SMS-tan (transaction authentication number delivered via text message). Findings will be disseminated through peer-reviewed journals and (inter)national conferences. TRIAL REGISTRATION NUMBER NTR7434.
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Affiliation(s)
- Joyce Vrijsen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ameen Abu-Hanna
- Department of Medical Informatics, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Els Lm Maeckelberghe
- Wenckebach Institute for Training and Education, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Peter Paul De Deyn
- Department of Neurology and Alzheimer Centre Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Fransje E Reesink
- Department of Neurology and Alzheimer Centre Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sophia E de Rooij
- Medical School Twente, Medical Spectrum Twente, Enschede, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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25
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Garcia-Ribas G, García-Arcelay E, Montoya A, Maurino J. Assessing Knowledge and Perceptions of Alzheimer's Disease Among Employees of a Pharmaceutical Company in Spain: A Comparison Between Caregivers and Non-Caregivers. Patient Prefer Adherence 2020; 14:2357-2364. [PMID: 33293798 PMCID: PMC7718989 DOI: 10.2147/ppa.s282147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Raising knowledge about Alzheimer's disease (AD) may help in identifying the disorder, seeking earlier appropriate healthcare, and decreasing its stigma. The aim of this study was to determine the knowledge and perceptions towards people with AD among employees of a pharmaceutical company in Spain. METHODS A non-interventional, cross-sectional study was conducted among 447 employees. Participants answered demographic questions and completed the Alzheimer's Disease Knowledge Scale (ADKS). Caregivers also answered questions related to their personal experience with patients with AD and completed the Satisfaction with Life Scale (SWLS), the Revised Memory and Behavior Problems Checklist (RMBPC), and the Beck Depression Inventory-Fast Screen (BDI-FS). RESULTS Participants were mostly between 30 and 50 years old (63%), female (65.3%), and had bachelor or master degrees (82.7%). Forty-two (9.4%) of participants were caregivers, mainly of moderate to severe dementia subjects. Overall knowledge about AD was moderate (mean ADKS score = 21.2 ± 2.8 [70.6% of correct answers]). Risk factors and caregiving were the domains with lowest scores (correct answers: 58.58% and 63%, respectively). Mean total ADKS score was significantly higher in participants caring for people with AD compared with non-caregivers (22.1 ± 2.9 and 21.0 ± 2.8; p=0.02, respectively). There was no statistically significant association between total ADKS score and age, sex, educational level, or relative's AD severity. Most caregivers were satisfied with life (mean SWLS score = 26.8 ± 5.6) showing a low impact from behavioral problems (mean RMBPC reaction score = 26.81 ± 20.2). Six of them (14.3%) were scored as depressed. CONCLUSION There is a continuing need to improve understanding of AD to fill the gaps in knowledge of the disease, even in a population working in healthcare sector with a high educational level.
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Affiliation(s)
| | - Elena García-Arcelay
- Medical Department, Roche Farma, Madrid, Spain
- Correspondence: Elena García-Arcelay Roche Farma, Ribera del Loira, 50, Madrid28042, SpainTel +34 91 324 81 00 Email
| | - Alonso Montoya
- Medical Affairs, Neuroscience, Hoffmann-La Roche Limited, Mississauga, ON, Canada
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