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Laver K, Connolly C, Priest L, Rahja M. Brain health and dementia prevention: getting the message across. Aging Ment Health 2025:1-3. [PMID: 40358001 DOI: 10.1080/13607863.2025.2478157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Accepted: 03/06/2025] [Indexed: 05/15/2025]
Affiliation(s)
- Kate Laver
- Caring Futures Institute, Flinders University, Adelaide, Australia
- Southern Adelaide Local Health Network, Adelaide, Australia
| | - Cath Connolly
- Caring Futures Institute, Flinders University, Adelaide, Australia
| | - Lauren Priest
- Southern Adelaide Local Health Network, Adelaide, Australia
| | - Miia Rahja
- Flinders Health and Medical Research Institute, Adelaide, Australia
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Sorrentino M, Fiorilla C, Mercogliano M, Stilo I, Esposito F, Moccia M, Lavorgna L, Salvatore E, Sormani MP, Majeed A, Triassi M, Palladino R. Barriers for access and utilization of dementia care services in Europe: a systematic review. BMC Geriatr 2025; 25:162. [PMID: 40065204 PMCID: PMC11892202 DOI: 10.1186/s12877-025-05805-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 02/18/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND Dementia is a group of chronic diseases characterised by cognitive impairment that progressively disrupts daily functioning and requires increasing levels of healthcare, social support, and long-term care. Support for people with dementia can be provided by formal support systems although most of the care process relies upon informal care givers. Despite the availability of formal support systems and healthcare workers, the utilization of dementia care services remains suboptimal. Factors such as non-compliance, lack of awareness, and poor care coordination contribute to this issue. Understanding these barriers is crucial for improving service utilization and alleviating the economic burden on families and national health systems. METHODS This systematic review analysed the literature, published from 2013 to 2023, on barriers in Alzheimer and other dementia healthcare system, conducted on people living with a dementia, their caregivers, or healthcare workers in dementia care settings in Europe, following PRISMA guidelines. Searches in PubMed, Embase, PsycINFO, Health Technology Assessment Database, and Web of Science used terms related to Alzheimer's, dementia, and access barriers. Rayyan AI supported full-text review, with quality assessed via the Mixed Methods Appraisal Tool. RESULTS Over 1298 articles, 29 studies met the inclusion criteria. These studies highlighted several barriers to dementia care, categorised into information, organizational, cultural, stigma-related, financial, and logistical challenges. Informational and educational barriers included a lack of awareness and knowledge among caregivers. Organizational barriers involved poor care coordination and unclear access procedures. Cultural and stigma-related barriers were linked to societal attitudes towards dementia. Financial barriers were associated with the high costs of care, and logistical barriers included limited availability and accessibility of support services. CONCLUSIONS To enhance the quality of life for individuals living with dementia, it is crucial to address these identified barriers through tailored interventions and management programs. Improving care coordination, communication, and training for healthcare professionals, alongside reducing systemic delays, are essential steps toward more effective dementia care. Easing the burden of care with tailored interventions and management programmes is mandatory to improve the quality of life of persons living with dementia and their families.
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Affiliation(s)
- Michele Sorrentino
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
- PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100, Pavia, Italy
| | - Claudio Fiorilla
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | | | - Irene Stilo
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Federica Esposito
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Marcello Moccia
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Luigi Lavorgna
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy
| | - Elena Salvatore
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
| | - Maria Triassi
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University "Federico II" of Naples, Naples, Italy.
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK.
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131, Naples, Italy.
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Martinez Escobedo I, Doherty K, Eccleston C. "Infographing" Dementia Prevention: A Co-Design Approach. HEALTH COMMUNICATION 2025; 40:512-521. [PMID: 38726586 DOI: 10.1080/10410236.2024.2350257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Designing effective public health messages is challenging, particularly when communicating complex and relatively new health messages such as dementia risk prevention which are still largely unfamiliar to the public. The accessibility of these messages, especially for individuals who speak English as an additional language, remains uncertain in large scale educational interventions. A key strategy to enhance the communication of evidence-based information is to co-design infographics that optimize the accessibility and impact of visual health messages. This paper reports on the co-design process of infographing dementia prevention messages. Qualitative data were analyzed using reflective thematic analysis to generate three themes reflecting the message design preferences of participants: "all hands on deck," "charting the course," and "get on board." This work supports the crucial need to engage the target audience via co-design when creating visual messages as meaningful and accessible educational tools that will resonate with the intended audience. Doing so may help health communicators navigate the creation of visual messages across diverse health domains and populations.
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Affiliation(s)
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania
| | - Claire Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania
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Moukarzel S, Araujo-Menendez CEE, Galang E, Zlatar ZZ, Feldman HH, Banks SJ. Tailoring implementation strategies for the healthy actions and lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia Program: Lessons learned from a survey study. J Prev Alzheimers Dis 2025; 12:100053. [PMID: 39827004 DOI: 10.1016/j.tjpad.2024.100053] [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: 10/22/2024] [Revised: 12/08/2024] [Accepted: 12/25/2024] [Indexed: 01/22/2025]
Abstract
BACKGROUND Healthy Actions and Lifestyles to Avoid Dementia Program (HALT-AD) or Hispanos y el ALTo a la Demencia is a recently-developed online educational platform to help individuals identify and modify their own dementia modifiable risk factors (MRF). In light of known challenges in recruiting and retaining diverse participants in research studies, there is a need to identify data-informed strategies that will contribute to effective outreach and tailored implementation of HALT-AD among its intended users of Hispanic and non-Hispanic midlife and older adults in the US. OBJECTIVES To identify factors (i.e, demographic, medical, psychosocial and environmental) that may facilitate or impede effective program enrollment and participation. DESIGN Cross-sectional study SETTING: Data from an online and self-administered survey conducted between January and April 2023 PARTICIPANTS: Residents of California, predominately San Diego, who were 50 to 85 years old, with no dementia or Alzheimer's disease, proficient in English or Spanish and with enough technical ability to complete the survey electronically (n=157; 43% Hispanic). INTERVENTION (IF ANY): none MEASUREMENTS: RedCap was used to capture answers to closed and open-ended survey questions. Mixed-methods analysis was used: For quantitative data, descriptive statistics, comparisons by group (Hispanic/non-Hispanic), and exploratory factor analysis were conducted in SPSS. Thematic analysis with open coding in Excel was used for qualitative responses. RESULTS Independent of ethnicity, participants' most preferred method of reach for recruitment was through a conversation with their doctor or with a family member or friend. Their least preferred method was receiving a Facebook advertisement especially among non-Hispanics. Interest in program participation did not differ by sociodemographic characteristics or self-rated satisfaction with individualized MRFs. Instead, having higher confidence in one's ability to commit to behavior change was significantly associated with higher interest in program participation. While a common theme to motivate both groups to participate was the potential to decrease dementia risk, non-Hispanics were motivated by the premise of supporting research and having a positive user experience. For program implementation, Hispanics were more likely to be interested in participating if live sessions, either online or in-person, were provided to offer support with making lifestyle changes as adjunct to completing online courses independently. In both groups, participation may be further facilitated by offering wearable devices which provide participants with feedback on lifestyle change progress. CONCLUSIONS A "one-size-fits-all" approach to recruitment and implementation of HALT-AD may not be effective in enrolling and retaining participants in future studies or for clinical use. Instead, a tailored approach that accounts for personal and ethnically-dependent preferences may be more beneficial.
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Affiliation(s)
- Sara Moukarzel
- Department of Neurosciences, University of California San Diego, San Diego, CA, 92037, USA; Alzheimer's Disease Cooperative Study, University of California San Diego, San Diego, CA, 92037, USA
| | | | - Eliza Galang
- Alzheimer's Disease Cooperative Study, University of California San Diego, San Diego, CA, 92037, USA
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92037, USA
| | - Howard H Feldman
- Department of Neurosciences, University of California San Diego, San Diego, CA, 92037, USA; Alzheimer's Disease Cooperative Study, University of California San Diego, San Diego, CA, 92037, USA
| | - Sarah J Banks
- Department of Neurosciences, University of California San Diego, San Diego, CA, 92037, USA; Department of Psychiatry, University of California San Diego, San Diego, CA, 92037, USA.
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Lazarova S, Petrova‐Antonova D. Gaps in dementia knowledge: a nationwide study of public awareness and misconceptions in Bulgaria. Psychogeriatrics 2025; 25:e70016. [PMID: 40016994 PMCID: PMC11868682 DOI: 10.1111/psyg.70016] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/05/2024] [Revised: 02/04/2025] [Accepted: 02/13/2025] [Indexed: 03/01/2025]
Abstract
BACKGROUND Dementia is a global health concern which can be mitigated by primary prevention and improved literacy. Effective educational initiatives are informed by studies of dementia knowledge. However, most of these studies are conducted in high-income countries, leaving the Balkan region underrepresented. This study aimed to conduct the first investigation of dementia knowledge among the Bulgarian population, exploring recognition of symptoms, general dementia knowledge, and risk factors awareness. METHODS Using an online survey we assessed the following components of knowledge: (i) recognition of dementia symptoms from a vignette; (ii) dementia literacy measured with the Dementia Knowledge Assessment Scale (DKAS); and (iii) knowledge about dementia risk factors. Demographic characteristics, previous experience with dementia, and patterns of informing about dementia were also considered in the study. RESULTS One thousand, eight hundred and ninety-six adults (mean age = 44.99; 51.79% female) completed the survey. Half of the respondents correctly recognised dementia symptoms from a vignette. The average DKAS score was 9.51. Dementia knowledge was linked to education, marital status, employment, ethnicity, experience with dementia, and informational sources. 56.7% of the respondents thought dementia was a normal part of ageing and 74.8% did not know a healthy lifestyle reduces the risk of dementia. The average number of identified risk factors was eight (out of 17), with many mistakenly citing dental fillings, laziness, and witchcraft as contributors to dementia. CONCLUSIONS The Bulgarian society has a poor understanding of dementia, highlighting the need for improved awareness and education. Policy-makers should prioritise dementia as a social issue and take coordinated actions to educate society and eradicate harmful misconceptions.
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Affiliation(s)
- Sophia Lazarova
- GATE InstituteSofia University “St. Kliment Ohridski”SofiaBulgaria
| | - Dessislava Petrova‐Antonova
- GATE InstituteSofia University “St. Kliment Ohridski”SofiaBulgaria
- Faculty of Mathematics and InformaticsSofia University “St. Kliment Ohridski”SofiaBulgaria
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Kohli M, Verstaen A, Trittschuh EH. Factors Associated With Life Satisfaction Among Veterans Enrolled in the Healthy Aging Project-Brain (HAP-B) Psychoeducational Class. J Appl Gerontol 2025:7334648241310948. [PMID: 39933782 DOI: 10.1177/07334648241310948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2025] Open
Abstract
Healthy Aging Project-Brain (HAP-B) is a novel clinical psychoeducation offering developed to encourage engagement in activities associated with successful aging. HAP-B targets sleep, socialization, physical, and cognitive activity through myth-busting, developing SMART goals, and tracking behavioral change. Study aims: (1) assess feasibility/acceptability in a Veteran population; (2) analyze pre- and post-intervention ratings to examine health and well-being; (3) explore associations between health factors and life satisfaction. The 50 participants (mean age = 70.6 years) were predominantly male-identity (88%) and White (76%). Findings, based on independent t tests, revealed improvements in life satisfaction, emotional well-being, and energy levels post-intervention. Linear regression results found higher life satisfaction was associated with lower depressive symptoms, higher emotional well-being, and higher self-efficacy. This easily implementable education intervention can result in more positive self-appraisal with encouraging downstream effects. Healthcare providers are well-positioned to utilize classes such as HAP-B to promote patient-centric approaches to brain health.
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Affiliation(s)
- Maulika Kohli
- VA Puget Sound Health Care System, Geriatric Research Education and Clinical Center, Seattle, WA, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Alice Verstaen
- Licensed Clinical Psychologist and Clinical Quality Supervisor with Lyra Health, PA, USA
| | - Emily H Trittschuh
- VA Puget Sound Health Care System, Geriatric Research Education and Clinical Center, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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Booi L, Bridgeman K, Greene L, Gregory S, An H, Marquez M, Farina FR. Exploring brain health awareness and dementia risk in young adults: A focus group study. Public Health 2025; 239:179-184. [PMID: 39864278 DOI: 10.1016/j.puhe.2024.12.035] [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: 06/19/2024] [Revised: 11/21/2024] [Accepted: 12/17/2024] [Indexed: 01/28/2025]
Abstract
OBJECTIVE The topic of brain health across the life-course is currently receiving exponential attention. Alongside this, exposure to lifestyle-related risk factors for Alzheimer's disease and related dementias accumulates across the life-course. This study aimed to explore young adults' (18-39 years) perceptions and understanding of brain health and dementia risk. STUDY DESIGN This study employed a phenomenological descriptive qualitative methodology to examine the lived experiences and perceptions of participants. METHODS Focus groups were conducted with 39 young adults (18 female, 2 non-binary) from North America (n = 20) and Europe (n = 19), conducted via video conference. RESULTS Participants' awareness and understanding of brain health and dementia risk factors varied, influenced by factors such as general health, family history of dementia, and personal experiences with brain health issues (e.g., traumatic brain injury). The data revealed rich insights into how participants connected (or did not connect) lifestyle factors to brain health and dementia risk. CONCLUSION This study is among the first to explore young adults' perceptions of brain health across diverse populations. While participants demonstrated moderate awareness of factors affecting brain health, they often struggled to link these factors directly to dementia risk or protective measures.
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Affiliation(s)
- Laura Booi
- Centre for Dementia Research, School of Health, Leeds Beckett University, Leeds, LS1 3HE, UK; Global Brain Health Institute, Trinity College, Dublin, Ireland and University of California, San Francisco, CA, 94158, USA.
| | - Katie Bridgeman
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, EH16 4SB, Edinburgh, UK
| | - Leanne Greene
- Centre for Dementia Research, School of Health, Leeds Beckett University, Leeds, LS1 3HE, UK
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, EH16 4SB, Edinburgh, UK
| | - Hosanna An
- University of Chicago, Pritzker School of Medicine, Chicago, IL, 60637, USA
| | - Melissa Marquez
- University of Chicago, Pritzker School of Medicine, Chicago, IL, 60637, USA
| | - Francesca R Farina
- Global Brain Health Institute, Trinity College, Dublin, Ireland and University of California, San Francisco, CA, 94158, USA; University of Chicago, Pritzker School of Medicine, Chicago, IL, 60637, USA
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Jeon YH, Simpson J, Fethney J, Krein L, Shin M, Low LF, Woods RT, Mowszowski L, Hilmer S, Naismith SL, Clemson L, Brodaty H, Naganathan V, Miller Amberber A, Kenny D, Gitlin L, Szanton S. Effectiveness of the Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence of people living with dementia: a multicentre, pragmatic, randomised, open-label, controlled trial. J Neurol Neurosurg Psychiatry 2025:jnnp-2024-334514. [PMID: 39824599 DOI: 10.1136/jnnp-2024-334514] [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: 06/24/2024] [Accepted: 12/01/2024] [Indexed: 01/20/2025]
Abstract
BACKGROUND We investigated the effectiveness of an Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence, health and well-being of people with dementia, family carer outcomes and costs. METHOD A multicentre pragmatic parallel-arm randomised controlled trial compared I-HARP to usual care in community-dwelling people with mild to moderate dementia and their family carers in Sydney, Australia (2018-2022). I-HARP is a 4-month, home-based, dementia rehabilitation model delivered by an interdisciplinary team. Assessments were conducted at baseline (time-1), 4-month (time-2) and 12-month (time-3) follow-up. The primary outcome measure was the client's functional independence using the Disability Assessment for Dementia (DAD) scale at time-2, based on intention-to-treat analyses. RESULT Of 130 recruited client-carer dyads, 116 dyads (58/group) completed the trial. The I-HARP group were not significantly better in most outcome measures than usual care at both time-2 and time-3; with the only statistically significant difference being a reduction in home environment hazards at time-2. Post hoc subgroup analysis of 66 clients with mild dementia found significantly better functional independence in the intervention group compared with those in usual care: difference 8.99 on DAD (95% CI 1.21, 16.79) at time-2 and difference 12.16 (95% CI 1.93, 22.38) at time-3. Economic evaluation suggests potentially lower resource use in I-HARP compared with usual care, but the cost-effectiveness is uncertain. CONCLUSION Primary outcomes were not met for a population of people with dementia, with severity ranging from mild to moderate and severe. The I-HARP model appeared to benefit functional independence of participants with mild dementia, with potential cost savings. TRIAL REGISTRATION NUMBER ACTRN12618000600246.
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Affiliation(s)
- Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Judy Simpson
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Judith Fethney
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Luisa Krein
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mirim Shin
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lee-Fay Low
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert T Woods
- DSDC Wales, School of Health Sciences, Bangor University, Bangor, UK
| | - Loren Mowszowski
- Brain and Mind Centre and School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Hilmer
- Kolling Institute and Faculty of Medicine and Health, Northern Sydney Local Health District and The University of Sydney, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Brain and Mind Centre and School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Lindy Clemson
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Danelle Kenny
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Laura Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sarah Szanton
- Schools of Nursing, Medicine and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Andreoletti M, Blasimme A. Examining the prevention approach in National Dementia Plans from European and North American countries. FRONTIERS IN DEMENTIA 2025; 3:1463837. [PMID: 39830987 PMCID: PMC11738615 DOI: 10.3389/frdem.2024.1463837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 11/26/2024] [Indexed: 01/22/2025]
Abstract
Objectives This paper aims to provide a comprehensive review of National Dementia Plans (NDPs) from selected European and North American countries, focusing on the distinct prevention strategies outlined and the approaches employed for reducing dementia risk. Method The sample consisted of 16 NDPs from Austria, Canada, Finland, France, Germany, Greece, Ireland, Italy, Liechtenstein, Luxembourg, Malta, the Netherlands, Spain, Switzerland, the UK, and the USA. These NDPs were retrieved from the Alzheimer's Disease International (ADI) database, with regular updates checked on official governmental websites. A qualitative analysis was conducted to identify common themes related to the vision, goals, and corresponding actions and measures within these strategies. Results Our analysis revealed that dementia prevention is a strategic goal for most of the countries studied. Common actions identified include the identification of risk factors, advancing research, promoting healthy aging, increasing public awareness, and encouraging lifestyle interventions. Conclusion We discuss the limitations and challenges of these actions, and more broadly, of the NDPs in relation to the recent literature on the most effective approaches to preventing dementia. We suggest adopting a more "horizontal" approach to dementia prevention, which current NDPs overlook in favor of "vertical" paradigms.
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Affiliation(s)
| | - Alessandro Blasimme
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
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Magno M, Martins AI, Pais J, Cruz VT, Silva AG, Rocha NP. Sociodemographic and health predictors of adherence to self-administered computerized cognitive assessment. Digit Health 2025; 11:20552076251332774. [PMID: 40290274 PMCID: PMC12032462 DOI: 10.1177/20552076251332774] [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: 10/15/2024] [Accepted: 03/20/2025] [Indexed: 04/30/2025] Open
Abstract
Introduction Cognitive assessment is essential to detect early cognitive decline and guide interventions. Self-administered computerized assessment is a promising option for periodic cognitive screening in the general population. One of the most critical challenges to implementing cognitive screening in at risk populations is participants' adherence. However, there is insufficient evidence to determine which factors are essential for adherence to long-term digital cognitive screening. Aims This study aims to investigate potential sociodemographic and health predictors of adherence to a self-administered web-based cognitive monitoring, the Brain on Track (BoT), in the general population. Methods Participants (n = 347) were recruited from the general community. The participants were asked to perform one BoT test every 3 months for cognitive screening and were followed at two time points, namely, 1-year and 3- to 6-year follow-up. Regression models were used to investigate sociodemographic and health predictors of adherence to BoT use at 1 year and up to 6 years. Results Being older positively affects adherence to periodic cognitive screening for both follow-up periods. Being a female, having more years of formal education, presenting more BoT baseline correct answers and fewer BoT baseline incorrect answers, and reporting memory complaints positively affect adherence to periodic screening at 3 to 6 years of follow-up but not at 1-year follow-up. Discussion The identified determinants of adherence can be considered when planning long-term cognitive screening protocols to increase adherence. Specific strategies could be helpful to improve the adherence of participants who adhere less.
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Affiliation(s)
- Marisa Magno
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Ana Isabel Martins
- Center for Health Technology and Services Research – CINTESIS@RISE, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Joana Pais
- EPIUnit – Institute of Public Health, Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Neuroinova, Lda., Vila Nova de Gaia, Portugal
| | - Vítor Tedim Cruz
- EPIUnit – Institute of Public Health, Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Local Health Unit of Matosinhos, EPE, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Anabela G Silva
- Center for Health Technology and Services Research – CINTESIS@RISE, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Nelson Pacheco Rocha
- IEETA – Institute of Electronics and Informatics Engineering of Aveiro, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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Niechcial MA, Elhag SM, Potter LM, Dickson A, Gow AJ. Systematic review of what people know about brain health. Ageing Res Rev 2025; 103:102592. [PMID: 39581353 DOI: 10.1016/j.arr.2024.102592] [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: 09/13/2024] [Accepted: 11/16/2024] [Indexed: 11/26/2024]
Abstract
OBJECTIVES As we age our cognitive abilities can change. However, the degree of change experienced is influenced by a range of factors. To understand what the public know about risk and protective factors for cognitive ageing, a systematic review was conducted of studies considering what people know about brain health. METHOD The search strategy included quantitative and qualitative studies in English, including interviews, focus groups, questionnaires, surveys of beliefs about brain health (including predictions, opinions) in generally healthy adults. PubMed, PsycINFO, Scopus, and Web of Science were used for published peer-reviewed literature; and ProQuest Dissertations and Theses and National Grey Literature Collection, PsycExtra and Google searches for grey literature. RESULTS From 37,197 records, one hundred and one were included, comprising 71 quantitative (22 grey literature), 27 qualitative (1 grey literature) and 3 mixed-methods (1 grey literature). Studies were grouped into three themes: Concerns about cognitive ageing, Opportunities to promote brain health and Understanding dementia risk reduction and prevention. DISCUSSION Studies reported varying levels of knowledge of brain health, alongside some suggestions for brain health that were somewhat superficial and not always consistent with scientific consensus. There were differences between groups of participants who exhibited less knowledge of brain health, for example, men, older adults, those with lower education and incomes, and ethnic minorities. This review highlights the need for clear messaging around opportunities to promote brain health, including scientifically-endorsed lifestyle factors and more information on the mechanisms by which they operate.
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Affiliation(s)
- Malwina A Niechcial
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Shaimaa M Elhag
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Lauren M Potter
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Adele Dickson
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Alan J Gow
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK.
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Lazarova S, Petrova-Antonova D. Establishing a unified global framework for studying dementia knowledge: insights from a narrative review. Arch Public Health 2024; 82:242. [PMID: 39716220 DOI: 10.1186/s13690-024-01476-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Accepted: 12/12/2024] [Indexed: 12/25/2024] Open
Abstract
BACKGROUND With the global population aging rapidly, dementia has become a pressing public health challenge, affecting the cognitive functions and daily activities of older adults worldwide. Enhancing literacy about dementia is a proactive prevention strategy, yet the effectiveness of educational programs can vary based on the target population's background. Thus, understanding dementia knowledge levels across different communities and countries is essential for successful educational interventions. Despite the large аmount of studies, there is no common framework for studying dementia knowledge, leading to significant variability in methods and poor data comparability. METHODS A narrative review is conducted to examine the methodological variability in studies of dementia knowledge and to propose a unified framework for future investigations. We hypothesize that significant differences will be evident in the methodologies employed, particularly regarding knowledge domains, research designs, influencing factors, and assessments of attitudes toward dementia. RESULTS A total of 59 research publications published after 2000 were selected, revealing significant variability in approaches to studying dementia knowledge and confirming our hypothesis. We identified eight dementia knowledge domains and various sociodemographic and experiential correlates, along with commonly used complementary assessments. These findings were organized into a unified global framework comprising two core components-dementia knowledge domains and correlates-supplemented by a component addressing affective dispositions towards dementia and an action list to guide future research. The framework aims to provide a foundational basis for enhancing inter-study comparisons and deepening our understanding of dementia knowledge and attitudes across diverse communities. CONCLUSION Aligning methodologies for surveying dementia knowledge through a common framework can empower stakeholders to implement effective educational programs, fostering an informed and supportive environment for individuals affected by dementia.
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Affiliation(s)
- Sophia Lazarova
- GATE Institute, Sofia University "St. Kliment Ohridski", Sofia, 1504, Bulgaria.
| | - Dessislava Petrova-Antonova
- GATE Institute, Sofia University "St. Kliment Ohridski", Sofia, 1504, Bulgaria
- Faculty of Mathematics and Informatics, Sofia University "St. Kliment Ohridski", Sofia, 1504, Bulgaria
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13
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Peckham A, Maxfield M, James DL. "How will I ever know I didn't bring it on myself?": Navigating personal responsibility in public health messaging on dementia risk. DEMENTIA 2024; 23:1292-1306. [PMID: 39137933 DOI: 10.1177/14713012241270756] [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: 08/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Public health messaging increasingly emphasizes the importance of "lifestyle interventions" to reduce dementia risk. Our study aimed to understand how people interpret and respond to information about dementia risk. In a second sub-aim, we examined how these interpretations may contribute to dementia-related lifestyle stigma. RESEARCH DESIGN AND METHODS We engaged in a secondary analysis of 50 semi-structured interviews using a framework approach to understand, from the perspective of community-dwelling middle-aged and older adults, how they may interpret, make sense of, and respond to information about dementia risk and risk reduction. During the interpretive and narrative phase, the authors began to elucidate participant responses analytically and identified that these responses could be interpreted within the health locus of control literature. RESULTS Of the 23 participants who discussed dementia risk, 13 felt some sense of personal responsibility and control over their dementia risk. Of those 13, four participants believed they had personal responsibility and control and actively engaged in lifestyle interventions. The remaining nine participants also engaged in lifestyle interventions, aiming to find comfort in knowing they had done what they could to reduce their risk and working to alleviate self-attribution of blame if diagnosed with dementia. DISCUSSION AND IMPLICATIONS The tendency to internalize responsibility may inadvertently contribute to the stigmatization of dementia as a 'lifestyle disease' creating dementia-related lifestyle stigma. Recognizing the multifaceted nature of dementia risk, including environmental and external factors beyond individual control, is essential to combatting the 'lifestyle stigma' increasingly associated with the condition.
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Affiliation(s)
- Allie Peckham
- Edson College of Nursing and Health Innovation, Arizona State University, USA; Center for Innovation in Healthy and Resilient Aging, Arizona State University, USA
| | - Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, USA; Center for Innovation in Healthy and Resilient Aging, Arizona State University, USA
| | - Dara L James
- Edson College of Nursing and Health Innovation, Arizona State University, USA
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Akyol MA, Güney S, Özgül E, Akpinar Söylemez B, Küçükgüçlü Ö. What does the public really know about dementia? A community-based cross-sectional survey in Turkiye. Public Health Nurs 2024; 41:1322-1330. [PMID: 39194399 DOI: 10.1111/phn.13398] [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: 02/02/2024] [Revised: 07/26/2024] [Accepted: 08/15/2024] [Indexed: 08/29/2024]
Abstract
Despite the increasing burden of dementia, there has been no evaluation of the level of dementia knowledge among the general public in Turkiye. Thus, this study aimed to evaluate the public's knowledge regarding dementia and the factors predicting this knowledge. This is a community-based cross-sectional study. A survey was conducted with 1106 participants between April and August 2023. The research tools were demographic characteristics form, a Turkish version of the dementia knowledge assessment scale (DKAS-T), and a form focusing on sociodemographic information and questions related to the degree of dementia knowledge. The data were analyzed using descriptive statistics, correlation, and multiple regression. The mean score on the DKAS-T was 12.32 ± 6.05 (min: 0 points, max: 33 points) out of 34. The sample recorded an incorrect response for less than half of the items in the dementia knowledge scale. Adjusted R2 was used as explanatory power. Moreover, the results of the multiple regression analysis identified various factors that significantly predicted dementia knowledge scores: age, prior education about dementia, experience of caring for a PwD, interaction with a PwD, and self-reported risk of being diagnosed with dementia in the future. These variables accounted for 18.1% of the total variance of dementia knowledge. Dementia is not well known in the public. The finding underscores the need for targeted educational initiatives to enhance dementia knowledge in the Turkish population. Interventions should focus on addressing specific areas of deficiency identified in the DKAS-T.
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Affiliation(s)
- Merve Aliye Akyol
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Seda Güney
- Faculty of Nursing, Koc University, Topkapi, Istanbul, Turkey
| | - Ecem Özgül
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Izmir University of Economics, Izmir, Turkey
| | - Burcu Akpinar Söylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
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15
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Berlekamp M, Reifegerste D, Temmann LJ. Effects of Health Responsibility Frames on Attributions, Emotions, and Social Support Intentions in the Context of Dementias. HEALTH COMMUNICATION 2024; 39:3159-3169. [PMID: 38281921 DOI: 10.1080/10410236.2024.2307204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
When news stories cover health and diseases, they often address issues of responsibility. These responsibility frames can affect recipients' responsibility beliefs (i.e., attributions) and thereby affect emotions and motivations to support people affected by health problems. To date, it is not fully understood how responsibility frames affect these attributions, emotions, and social support intentions in the context of dementia. In an online experiment with N = 1,059 German participants, we tested the effects of different responsibility frames (individual vs. contextual) on social support intentions through responsibility attributions and emotional reactions in the context of dementia. Results show that responsibility frames affect responsibility attributions and social support intentions. Mediation analysis shows that the effect of contextual responsibility frames on social support intention is partially mediated by responsibility attribution and emotions (sympathy and anger). We discuss these findings considering framing effects research and media coverage.
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Affiliation(s)
- Mara Berlekamp
- Department of Media and Communication, Ludwig-Maximilians-Universität München
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16
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Timmins HC, Mok VC, Kim SH, Shahrizaila N, Sung JY, Sobue G, Agustini S, Ward S, Anstey KJ, Talbot DL, Mazumder S, Tu S, Tan RH, Shin-Yi Lin C, O’Callaghan C, Michaelian JC, Jeon YH, Foxe D, Naismith SL, Piguet O, Ahmed R, Devenney E, Park SB, Kiernan MC. Regional health priorities for dementia: a roadmap for the Western Pacific. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 50:101179. [PMID: 39399866 PMCID: PMC11471056 DOI: 10.1016/j.lanwpc.2024.101179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/01/2024] [Accepted: 08/12/2024] [Indexed: 10/15/2024]
Abstract
In the Western Pacific Region, the prevalence of dementia is expected to increase, however, the diversity of the region is expected to present unique challenges. The region has varying levels of preparedness, with a limited number of countries having a specific national dementia plan and awareness campaigns. Diversity of risk and healthcare services within the region is exerting impact on diagnosis, treatment, care, and support, with most countries being under resourced. Similarly, the ability to monitor dementia-related indicators and progress research, particularly relating to treatment and clinical trial access needs to be addressed. Countries require comprehensive national plans that lay out how resources will be allocated to improve dementia literacy, train, and support carers, mobilise resources to reduce risk factors and improve research capabilities. These plans need to be informed by consumers and tailored to the region to develop an inclusive society for people living with dementia and their families.
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Affiliation(s)
| | - Vincent C.T. Mok
- Gerald Choa Neuroscience Institute, Lau Tat Chuen Research Centre of Brain Degenerative Diseases in Chinese, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Seung Hyun Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Nortina Shahrizaila
- Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Jia-Ying Sung
- Department of Neurology, School of Medicine, Taipei Medical University, Taiwan
| | - Gen Sobue
- Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | | | - Stephanie Ward
- Centre for Healthy Brain Ageing, School of Psychiatry, The University of New South Wales, Sydney, Australia
- Department of Geriatric Medicine, The Prince of Wales Hospital, Sydney, Australia
| | - Kaarin J. Anstey
- Neuroscience Research Australia, Sydney, Australia
- UNSW Ageing Futures Institute, School of Psychology, University of New South Wales, Sydney, Australia
| | | | | | - Sicong Tu
- Neuroscience Research Australia, Sydney, Australia
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Rachel H. Tan
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | - Cindy Shin-Yi Lin
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Claire O’Callaghan
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | - Johannes C. Michaelian
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- Charles Perkins Centre, School of Psychology, Faculty of Science, University of Sydney, NSW, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Foxe
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Sharon L. Naismith
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- Charles Perkins Centre, School of Psychology, Faculty of Science, University of Sydney, NSW, Australia
| | - Olivier Piguet
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Rebekah Ahmed
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- Memory and Cognition Clinic, Department of Neuroscience, Royal Prince Alfred Hospital, Sydney, Australia
| | - Emma Devenney
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Australia
- Western Sydney Local Health District, Westmead Hospital, Westmead, Sydney, Australia
| | - Susanna B. Park
- Brain and Mind Centre, University of Sydney, Sydney, Australia
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | - Matthew C. Kiernan
- Neuroscience Research Australia, Sydney, Australia
- University of New South Wales, Sydney, Australia
- Department of Neurology, Prince of Wales Hospital, Sydney, Australia
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17
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Clarke AJ, Brodtmann A, Irish M, Mowszowski L, Radford K, Naismith SL, Mok VC, Kiernan MC, Halliday GM, Ahmed RM. Risk factors for the neurodegenerative dementias in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 50:101051. [PMID: 39399869 PMCID: PMC11471060 DOI: 10.1016/j.lanwpc.2024.101051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/04/2024] [Accepted: 03/12/2024] [Indexed: 10/15/2024]
Abstract
The Western Pacific Region (WPR) is characterized by a group of socioeconomically, culturally, and geopolitically heterogenous countries and represents a microcosm of the global endemic of neurodegeneration. This review will chart the known risk factors for dementia across the WPR. We explore the intersection between the established risk factors for dementia including the biomedical and lifestyle (cardiovascular and metabolic disease, sleep, hearing loss, depression, alcohol, smoking, traumatic brain injury, genetics) and social determinants (social disadvantage, limited education, systemic racism) as well as incorporate neuroimaging data, where available, to predict disease progression in the WPR. In doing so, we highlight core risk factors for dementia in the WPR, as well as geographical epicentres at heightened risk for dementia, to orient future research towards addressing these disparities.
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Affiliation(s)
- Antonia J. Clarke
- Department of Neurosciences, Monash University, Melbourne, VIC 3004 Australia
| | - Amy Brodtmann
- Department of Neurosciences, Monash University, Melbourne, VIC 3004 Australia
| | - Muireann Irish
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
| | - Loren Mowszowski
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Kylie Radford
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
- The University of New South Wales, Sydney, NSW 2031 Australia
| | - Sharon L. Naismith
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
| | | | - Matthew C. Kiernan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Glenda M. Halliday
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW 2050 Australia
| | - Rebekah M. Ahmed
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
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18
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Malaga M, Aguirre RJ, Alva-Diaz C, Custodio N, Lanata S, Montesinos R, Pintado-Caipa M. Knowledge of dementia and Alzheimer's disease among healthcare professionals in Peru. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-9. [PMID: 39341209 DOI: 10.1055/s-0044-1790576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2024]
Abstract
BACKGROUND Primary care physicians and other healthcare providers report feeling unprepared to treat persons with dementia (PWD), especially in developing countries OBJECTIVE: We aimed to assess the knowledge of dementia and Alzheimer's disease (AD) among health professionals in both primary and tertiary care in Peru. METHODS We conducted an in-person and virtual survey of healthcare professionals trained in Peru throughout the year 2020. The survey was developed based on a previously published one and reviewed by an expert panel. We compared groups using a Chi-squared test. A Bonferroni corrected p-value of 0.008 was used for statistical significance. RESULTS Out of 804 surveys, we excluded 56 due to incomplete data. A total of 41.6% of respondents were doctors and 21.8%, nurses. One fifth of participants did not recognize AD as a cause of dementia and over half considered "senile dementia" a valid clinical entity. Scores were higher among those with postgraduate training, multiple patients with dementia, or those who had practiced for over 10 years. CONCLUSION There is a low level of knowledge of dementia and AD among health professionals in Peru, which worsens outside of Lima. Pernicious ideas, such as senile dementia, are still significantly present among respondents.
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Affiliation(s)
- Marco Malaga
- Instituto Peruano de Neurociencias, Unidad de Investigación de Deterioro Cognitivo y Prevención de Demencia, Lima, Peru
- Universidad Científica del Sur, Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública, Lima, Peru
| | - Rafhael J Aguirre
- Universidad Cientifica del Sur, Facultad de Medicina Humana, Lima, Peru
| | - Carlos Alva-Diaz
- Universidad Científica del Sur, Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública, Lima, Peru
- Hospital Daniel Alcides Carrión, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Servicio de Neurología, Callao, Peru
| | - Nilton Custodio
- Instituto Peruano de Neurociencias, Unidad de Investigación de Deterioro Cognitivo y Prevención de Demencia, Lima, Peru
- Universidad Privada San Juan Bautista, Escuela Profesional de Medicina Humana, Lima, Peru
| | - Serggio Lanata
- University of California, Weill Institute for Neurosciences, Memory and Aging Center, Department of Neurology, San Francisco CA, United States
| | - Rosa Montesinos
- Instituto Peruano de Neurociencias, Unidad de Investigación de Deterioro Cognitivo y Prevención de Demencia, Lima, Peru
| | - Maritza Pintado-Caipa
- University of California, Global Brain Health Institute, San Francisco CA, United States
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Kappe J, Wittmann F, Luppa M, Cardona MI, Weise S, Fuchs S, Kosilek RP, Sanftenberg L, Brettschneider C, Döhring J, Escales C, Czock D, Wiese B, Thyrian JR, Hoffmann W, Frese T, Gensichen J, König HH, Kaduszkiewicz H, Riedel-Heller SG. General practitioners' perspectives on lifestyle interventions for cognitive preservation in dementia prevention. BMC PRIMARY CARE 2024; 25:301. [PMID: 39143540 PMCID: PMC11323454 DOI: 10.1186/s12875-024-02566-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND General practitioners (GPs) play a crucial role in identifying cognitive impairment and dementia and providing post-diagnostic care. This study investigates (1) how promising GP consider lifestyle changes to maintain cognitive performance in general, (2) GP beliefs about the power of modifiable health and lifestyle factors to maintain cognitive performance, and (3) whether those beliefs vary by GP age. METHODS As part of the AgeWell.de trial, GPs (n = 72) completed a process evaluation questionnaire assessing their perspectives on lifestyle changes to preserve cognitive performance in elderly patients. In greater detail, their perceived efficacy of established risk and protective factors was investigated using a 5-point Likert scale. Descriptive statistical analyses were performed for research question (1) and (2). Spearman´s rank correlations and ordinal logistic regressions were used to answer research question (3). All results were interpreted exploratively. RESULTS GPs rated the overall chance of lifestyle changes maintaining cognitive performance quite neutral with a median score of 3.0 (IQR = 2.0). They rated the efficacy of all the modifiable health and lifestyle factors high, with increase in physical and social activity ((Mdn = 5.0, IQR = 1.0) receiving the highest ratings with the narrowest range. Spearman's rank correlation indicated a significant positive relationship between age and the belief in "Optimization of nutrition" for preventing cognitive decline and dementia (ρ = .255, p = .041). However, ordinal logistic regressions showed no significant relationships between age and GP ratings of lifestyle change efficacy. CONCLUSION These findings highlight the positive perception of GPs on the efficacy of modifiable health and lifestyle factors for preventing cognitive decline and dementia. TRIAL REGISTRATION The AgeWell.de trial is registered in the German Clinical Trials Register (DRKS; trial identifier: DRKS00013555, Registration Date 07 December 2017).
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Affiliation(s)
- Josefine Kappe
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Phillip-Rosenthal-Str. 55, Leipzig, 04103, Germany.
| | - Felix Wittmann
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Phillip-Rosenthal-Str. 55, Leipzig, 04103, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Phillip-Rosenthal-Str. 55, Leipzig, 04103, Germany
| | - Maria Isabel Cardona
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
| | - Solveign Weise
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| | - Stephan Fuchs
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| | - Robert Philipp Kosilek
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, Kiel, Germany
| | | | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, 69120, Germany
| | - Birgitt Wiese
- Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Jochen René Thyrian
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Greifswald, Germany
- Faculty V: School of Life Sciences, University of Siegen, Siegen, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Greifswald, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Steffi Gerlinde Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Phillip-Rosenthal-Str. 55, Leipzig, 04103, Germany
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20
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Chalhoub TM, Mackenzie E, Siette J. "Establishing healthy habits and lifestyles early is very important": parental views of brain health literacy on dementia prevention in preschool and primary school children. Front Public Health 2024; 12:1401806. [PMID: 39165778 PMCID: PMC11333320 DOI: 10.3389/fpubh.2024.1401806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
Introduction Parents have the potential to drive healthy lifestyle behaviors through educational initiatives. This study aims to understand the prevalent thoughts and perceptions parents have toward brain health educational programs for preschool and primary school settings, whilst also contributing to a comprehensive understanding of the role parents can play in the broader context of dementia reduction strategies and the cultivation of brain health awareness among children. Methods Parents with children aged between 2 and 11 years old were interviewed about their current knowledge of dementia, prior beliefs, current lifestyle factors and opinions on educating their children from a young age on the topic of dementia literacy. Thematic deductive analysis was employed to systematically categorize and interpret the qualitative data obtained from these interviews. Results Thirty parents (M age = 38.6, SD = 4.9, Range = 32-48) identified three core themes on nurturing bodies and minds (e.g., conceptualizing the link between intellectual engagement, continuous learning, and the prevention of cognitive decline), brain health literacy (e.g., current knowledge and awareness of brain health, dementia and associated stigma, and provision of age-appropriate health literacy) and parental concerns (i.e., barriers to initiating conversations about dementia with children and strategies to address and alleviate parental concerns). Parents possessing prior knowledge of dementia and its modifiable risk factors exhibited greater propensity to educate their children on the associated risk factors. Conclusion Our study highlights the vital influence of parents' experiences, health literacy, and education on the acceptance of brain health education for children. Future interventions should target stigma reduction, enhance awareness, and offer accessible information on modifiable dementia risk factors, enabling a conducive environment for active parental involvement in educating children about brain health and contributing to future well-being.
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Affiliation(s)
- Tayla M. Chalhoub
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
| | - Erin Mackenzie
- School of Education, Western Sydney University, Kingswood, NSW, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
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21
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Sharif AB, Jahan I, Hasan AN. Knowledge, Awareness, and Perceived Threat Toward Alzheimer's Disease Among the Family Caregivers of Individuals with Chronic Physical Conditions in Bangladesh. J Alzheimers Dis Rep 2024; 8:1041-1054. [PMID: 39114554 PMCID: PMC11305851 DOI: 10.3233/adr-240055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/18/2024] [Indexed: 08/10/2024] Open
Abstract
Background Alzheimer's disease (AD) is a growing public health concern affecting millions of individuals worldwide. This disease burden is exacerbated in countries like Bangladesh, where public awareness and knowledge about the condition remains limited. Objective This study aimed to assess the level of AD knowledge, awareness, and perceived threat among family caregivers of individuals with chronic physical conditions of Bangladesh. Methods A descriptive cross-sectional study was conducted among the caregivers of patients selected via convenience sampling in six public hospitals between October 2022 and March 2023. The data was collected via face-to-face interviews employing a semi-structured questionnaire that contained information about socio-demographic characteristics, personal experiences with AD, knowledge of AD, level of awareness regarding AD, and perceived threat toward AD. Results The findings revealed a poor knowledge of AD among the study participants. Regarding AD awareness, 52.5% considered memory loss in older individuals abnormal, 26.2% attributed AD to causes like black magic, psychological distress, or bad eyes. Regarding perceived threat, 60.2% wanted to assess their AD risk, while 68.2% disagreed with the likelihood of developing the disease. Multiple linear regression analysis revealed that age, place of residence, education, and employment status significantly contribute to AD knowledge scores. Conclusions This study highlights the urgent need for public education and awareness campaigns to address the knowledge gap and reduce stigmatization associated with AD in Bangladesh. Targeted efforts, particularly among older age groups and rural communities, can enhance understanding and improve the quality of care and support for AD patients and their caregivers.
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Affiliation(s)
- Azaz Bin Sharif
- North South University Global Health Institute, Dhaka, Bangladesh
| | - Ishrat Jahan
- North South University Global Health Institute, Dhaka, Bangladesh
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Jeyagurunathan A, Yuan Q, Samari E, Zhang Y, Goveas R, Ng LL, Subramaniam M. Facilitators and barriers of help-seeking for persons with dementia in Asia-findings from a qualitative study of informal caregivers. Front Public Health 2024; 12:1396056. [PMID: 39071142 PMCID: PMC11282579 DOI: 10.3389/fpubh.2024.1396056] [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: 03/05/2024] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Background and aim The deterioration in cognition of persons with dementia (PWD) makes their caregivers key players in their help-seeking process. This study aimed to identify the facilitators and barriers of help-seeking for persons with dementia in Asia from the perspective of their informal caregivers. Methods A qualitative methodology was adopted in the current study. Twenty-nine informal caregivers of PWD in Singapore were interviewed between April 2019 and December 2020. All interviews were audio-recorded and transcribed verbatim for the analysis. Results The transcripts were analyzed using inductive thematic analysis. The results revealed four major themes with 12 sub-themes, including (1) Barriers to diagnosis-seeking (i.e., lack of knowledge and awareness of dementia, emotional denial, resistance from PWD, and delays in the healthcare system); (2) Facilitators of diagnosis-seeking (i.e., synergy between awareness of dementia and an active diagnosis-seeking intention and incidental diagnosis resulting from seeking treatment for comorbid conditions); (3) Barriers to treatment-seeking (i.e., challenges from PWD and disease, challenges faced by caregivers when seeking treatment for PWD, and challenges imposed by the COVID-19 pandemic); (4) Facilitators of treatment-seeking (i.e., caregivers' capabilities of handling PWD, cooperation/compliance from PWD, and an integrated care plan for PWD). Conclusion The findings highlight the importance of raising public awareness, enabling health professionals to tailor psychosocial interventions better, and improving community support through dementia awareness and education.
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Affiliation(s)
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
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Farina N, Hassan E, Theresia I, Fitri FI, Suswanti I, Sani TP, Evans‐Lacko S, Banerjee S, Turana Y. Awareness, attitudes, and beliefs of dementia in Indonesia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12570. [PMID: 38617185 PMCID: PMC11010264 DOI: 10.1002/dad2.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Tackling dementia stigma is a policy priority. In Indonesia, we have little insight into the general public's knowledge and attitudes about dementia. METHODS Cross-sectional study of 4430 Indonesian adults recruited from Jakarta and North Sumatra, Indonesia. Measures included dementia knowledge and attitudes. RESULTS A total of 86.3% (n = 3,803) of adults had not heard of the terms dementia or Alzheimer's disease, and commonly viewed dementia as a normal part of aging. Being older, incorrect knowledge about etiology, not having heard of the terms dementia and/or Alzheimer's disease, having less than primary education, and being from North Sumatra were associated with more negative attitudes (p-values < 0.05). DISCUSSION Misconceptions and lack of awareness about dementia are common in Indonesia. Attitudes tended not to be negative, but our research highlights factors associated with dementia attitudes. Future research should use this information to better tailor and target potential anti-stigma strategies. Highlights Most Indonesians had not heard of the terms dementia and/or Alzheimer's disease and thought it was caused by normal aging.The majority of participants held mixed or positive attitudes towards dementia.A series of demographic factors alongside poor awareness were associated with negative attitudes towards dementia.
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Affiliation(s)
| | - Esra Hassan
- Centre for Dementia Studies, Brighton and Sussex Medical SchoolEast SussexUK
| | | | - Fasihah Irfani Fitri
- Department of Neurology, Faculty of MedicineUniversitas Sumatera UtaraMedanIndonesia
| | - Ika Suswanti
- Department of NeurologySchool of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | | | - Sara Evans‐Lacko
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Sube Banerjee
- Faculty of Medicine and Health SciencesUniversity of NottinghamNottinghamUK
| | - Yuda Turana
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
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Paauw D, Heger I, Bjerre JF, Ringgaard MF, Stensgård V, Horstkötter D, Köhler S, Deckers K. Increasing awareness for dementia risk reduction through a public awareness campaign in Denmark: A pre-post study. Prev Med 2024; 179:107848. [PMID: 38215992 DOI: 10.1016/j.ypmed.2024.107848] [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: 08/29/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE It is estimated that about 40% of all dementia cases are potentially attributable to modifiable risk factors, but awareness of this is relatively lacking. METHODS An 18-months nation-wide public awareness campaign on dementia risk reduction was rolled out in Denmark that combined a mass-media approach with an online risk assessment tool and knowledge bank targeting all inhabitants aged between 40 and 75 years. Campaign effects (increase in awareness and knowledge of modifiable dementia risk and protective factors) were assessed via online surveys in two independent random samples before (n = 1003) and after the campaign (n = 1076). RESULTS After adjusting for differences in educational level between the two samples, there was no significant difference in awareness of dementia risk reduction between the pre-campaign (66.5% aware) and post-campaign (63.4% aware) sample (probit z = -0.08, p = 0.151). The number of correctly identified risk/protective factors was significantly higher in the post-campaign sample. After adjusting for potential confounding factors, self-reported exposure to the campaign was associated with more awareness, better recognition of risk/protective factors, more motivation for and actual implementation of lifestyle changes. CONCLUSIONS This mass-media campaign did not increase overall awareness that dementia risk is partly modifiable. However, exposure to the campaign was associated with more awareness and willingness to take action to improve brain health. Future campaigns should tailor messages to specific subgroups to broaden the reach (e.g., males), co-create materials with the target group, and give special attention to the contribution of metabolic/cardiovascular risk factors to dementia risk.
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Affiliation(s)
- Dominique Paauw
- Alzheimer Centre Limburg, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Irene Heger
- Alzheimer Centre Limburg, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | | | | | | | - Dorothee Horstkötter
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands; Department of Health Ethics and Society, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centre Limburg, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centre Limburg, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.
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Uysal HA, Güllüoğlu H, Poyraz T, Başaran S, Var L, Eşkut N. Validity and Reliability of the Turkish Version of the Behavioral and Psychological Symptoms of Dementia Knowledge Scale (BPSD-T): A Psychometric Evaluation Among Caregivers. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:295-305. [PMID: 39783805 PMCID: PMC11681267 DOI: 10.5080/u27614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 11/22/2024] [Indexed: 01/12/2025]
Abstract
OBJECTIVE This study aimed to validate the Turkish version of the Behavioral and Psychological Symptoms of Dementia Knowledge Scale (BPSD-T) among caregivers. The goal was to assess the scale's psychometric properties, ensuring it accurately measures caregivers' knowledge of dementia-related behavioral and psychological symptoms in a Turkish context. METHODS In this cross-sectional study, the data were collected from 212 caregivers providing home-based care to dementia patients across Turkey. Participants completed a 12-item Behavioral and Psychological Symptoms of Dementia (BPSD) knowledge questionnaire along with a sociodemographic form. To examine the factor structure of the scale, both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Sample adequacy for EFA was assessed using the Kaiser- Meyer-Olkin (KMO) measure and Bartlett's test of sphericity. For CFA, model fit was evaluated using fit indices such as χ2/df, Goodness of Fit Index (GFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), and Root Mean Square Error of Approximation (RMSEA). The internal consistency of the scale was assessed with Cronbach's alpha coefficient. RESULTS The findings showed that the BPSD-T has strong internal consistency (Cronbach's alpha=0.85) and a robust factor structure. Factor loadings ranged from 0.396 to 0.744, supporting the construct validity of the scale. Item-total correlations ranged from 0.437 to 0.711, with the item "BPSD are the major source of caregiving burden" having the highest correlation (r=0.711). The results indicate that the BPSD-T is a reliable instrument for assessing caregivers' knowledge of behavioral and psychological symptoms associated with dementia. CONCLUSION The BPSD-T provides an effective means of identifying knowledge gaps among caregivers in Turkey and serves as a valuable tool for developing training programs aimed at improving the management of BPSD. This study contributes to the literature by validating the scale in a non-Western context, suggesting that enhancing caregivers' knowledge of BPSD can have positive impacts on clinical management and patient care. In this regard, the implementation of the BPSD-T may support the more effective management of behavioral and psychological symptoms in dementia patients.
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Affiliation(s)
- Hasan Armağan Uysal
- Neurologist, Izmir University of Economics Faculty of Medicine, Department of Neurology, Izmir, Turkey
| | - Halil Güllüoğlu
- Neurologist, Izmir University of Economics Faculty of Medicine, Department of Neurology, Izmir, Turkey
| | - Turan Poyraz
- Neurologist, Izmir University of Economics ,Health Services Vocational School, Elderly Care Department, Izmir, Turkey
| | - Simay Başaran
- MD, Izmir University of Economics Medicalpoint Hospital, Department of Neurology, Izmir, Turkey
| | - Levent Var
- Neurologist, Noron Medical Center, Department of Psychiatry, Izmir, Turkey
| | - Neslihan Eşkut
- Neurologist, Izmir City Hospital, Department of Neurology, Izmir, Turkey
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van de Schraaf SA, Rhodius-Meester HF, Rijnsent LM, Natawidjaja MD, van den Berg E, Wolters FJ, Visser-Meily JA, Biessels GJ, de Vugt M, Muller M, Hertogh CM, Sizoo EM. Healthcare Professionals' Perspectives on Post-Diagnostic Care for People with Vascular Cognitive Impairment: When Help Is Needed in a "No-Man's Land". J Alzheimers Dis 2024; 101:1001-1013. [PMID: 39240640 PMCID: PMC11492012 DOI: 10.3233/jad-240526] [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: 07/18/2024] [Indexed: 09/07/2024]
Abstract
Background Post-diagnostic care for people with vascular cognitive impairment (VCI) typically involves multiple professions and disjointed care pathways not specifically designed to aid VCI needs. Objective Exploring perspectives of healthcare professionals on post-diagnostic care for people with VCI. Methods We conducted a qualitative focus group study. We used purposive sampling to include healthcare professionals in different compositions of primary and secondary care professionals per focus group. Thematic saturation was reached after seven focus groups. Transcripts were iteratively coded and analyzed using inductive thematic analysis. Results Forty participants were included in seven focus groups (4-8 participants). Results showed knowledge and awareness of VCI as prerequisites for adequate post-diagnostic care, and for pre-diagnostic detection of people with VCI (theme 1). In light of perceived lack of differentiation between cognitive disorders, participants shared specific advice regarding post-diagnostic care for people with VCI and informal caregivers (theme 2). Participants thought current care for VCI was fragmented and recommended further integration of care and collaboration across settings (theme 3). Conclusions People with VCI and their caregivers risk getting stuck in a "no man's land" between post-diagnostic care pathways; challenges lie in acknowledgement of VCI and associated symptoms, and alignment between healthcare professionals. Education about the symptoms and consequences of VCI, to healthcare professionals, people with VCI and caregivers, may increase awareness of VCI and thereby better target care. Specific attention for symptoms common in VCI could further tailor care and reduce caregiver burden. Integration could be enhanced by combining expertise of dementia and stroke/rehabilitation pathways.
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Affiliation(s)
- Sara A.J. van de Schraaf
- Medicine for Older People, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Internal Medicine, Geriatric Medicine Section, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
| | - Hanneke F.M. Rhodius-Meester
- Internal Medicine, Geriatric Medicine Section, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Neurology, Alzheimer Center Amsterdam, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Lindsey M. Rijnsent
- Medicine for Older People, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | | | - Esther van den Berg
- Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frank J. Wolters
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - J.M. Anne Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Centre Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert Jan Biessels
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marjolein de Vugt
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Majon Muller
- Internal Medicine, Geriatric Medicine Section, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis & Ischemic Syndromes, Amsterdam, The Netherlands
| | - Cees M.P.M. Hertogh
- Medicine for Older People, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
| | - Eefje M. Sizoo
- Medicine for Older People, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
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de la Perrelle L. Health Care Is Not Enough to Prevent Dementia. J Alzheimers Dis 2024; 97:951-952. [PMID: 38250780 DOI: 10.3233/jad-231348] [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: 01/23/2024]
Abstract
With an aging population, an increase in cases of Alzheimer's disease and dementia worldwide poses a significant health burden. While we hope for a cure, preventing dementia by reducing risks is important for global population health. Prevention strategies are difficult to implement when facing inequality across the world for access to healthy lifestyles. An approach that centers on individual responsibility and health professional interventions for targeted groups may risk missing the policy and environmental drivers of change. Barriers and enablers need to be explored and interventions are needed at individual, structural and social levels to normalize mid-life risk reduction.
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Affiliation(s)
- Lenore de la Perrelle
- College of Education, Psychology and Social Work and College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Van Asbroeck S, Köhler S, Wimmers SC, Muris JW, van Boxtel MP, Deckers K. Multidomain Dementia Risk Reduction in Primary Care is Feasible: A Proof-of-concept study. J Alzheimers Dis 2024; 99:1455-1471. [PMID: 38759017 PMCID: PMC11191460 DOI: 10.3233/jad-240229] [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: 04/19/2024] [Indexed: 05/19/2024]
Abstract
Background Dementia risk reduction is a public health priority, but interventions that can be easily implemented in routine care are scarce. Objective To evaluate the feasibility of integrating dementia risk reduction in regular consultations in primary care and the added value of a dedicated smartphone app ('MyBraincoach'). Methods 188 participants (40-60 years), with modifiable dementia risk factors were included from ten Dutch general practices in a cluster-randomized trial (NL9773, 06/10/2021). Practices were randomly allocated (1 : 1) to provide a risk-reduction consultation only or to additionally provide the app. During the consultation, participants learned about dementia risk reduction and how to improve their risk profile. The app group received daily microteaching-notifications about their personally relevant risk factors. Feasibility was evaluated after 3 months using questionnaires assessing knowledge on dementia risk reduction and health behavior change. The primary outcome was change in the validated "LIfestyle for BRAin health" (LIBRA) score. In-depth interviews were conducted with participants and primary care providers (PCPs). Results The interventions were positively perceived, with 72.0% finding the consultation informative and 69.2% considering the app useful. Drop-out was low (6.9%). LIBRA improved similarly in both groups, as did Mediterranean diet adherence and body mass index. Knowledge of dementia risk reduction increased, but more in the app group. Interviews provided insight in participants' and PCPs' needs and wishes. Conclusions Integrating dementia risk reduction in primary care, supported by a smartphone app, is a viable approach towards dementia risk reduction. Larger trials are needed to establish (cost-)effectiveness.
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Affiliation(s)
- Stephanie Van Asbroeck
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Sophie C.P.M. Wimmers
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Jean W.M. Muris
- Department of Family Medicine, Careand Public Health Research Institute (CAPHRI), MaastrichtUniversity, Maastricht, the Netherlands
| | - Martin P.J. van Boxtel
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, the Netherlands
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Moukarzel S, Zlatar ZZ, Hartman SJ, Lomas D, Feldman HH, Banks SJ, HALT‐AD Study Group. Developing the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia program. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12457. [PMID: 38440783 PMCID: PMC10909928 DOI: 10.1002/trc2.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION With Alzheimer's disease and related dementias (ADRD) representing an enormous public health challenge, there is a need to support individuals in learning about and addressing their modifiable risk factors (e.g., diet, sleep, and physical activity) to prevent or delay dementia onset. However, there is limited availability for evidence-informed tools that deliver both quality education and support for positive behavior change such as by increasing self-efficacy and personalizing goal setting. Tools that address the needs of Latino/a, at higher risk for ADRD, are even more scarce. METHODS We established a multidisciplinary team to develop the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia (HALT-AD) program, a bilingual online personalized platform to educate and motivate participants to modify their risk factors for dementia. Grounded in social cognitive theory and following a cultural adaptation framework with guidance from a community advisory board, we developed HALT-AD iteratively through several cycles of rapid prototype development, user-centered evaluation through pilot testing and community feedback, and refinement. RESULTS Using this iterative approach allowed for more than 100 improvements in the content, features, and design of HALT-AD to improve the program's usability and alignment with the interests and educational/behavior change support needs of its target audience. Illustrative examples of how pilot data and community feedback informed improvements are provided. DISCUSSION Developing HALT-AD iteratively required learning through trial and error and flexibility in workflows, contrary to traditional program development methods that rely on rigid, pre-set requirements. In addition to efficacy trials, studies are needed to identify mechanisms for effective behavior change, which might be culturally specific. Flexible and personalized educational offerings are likely to be important in modifying risk trajectories in ADRD.
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Affiliation(s)
- Sara Moukarzel
- Department of NeurosciencesUniversity of California San DiegoSan DiegoCaliforniaUSA
- Alzheimer's Disease Cooperative StudyUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Zvinka Z. Zlatar
- Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Sheri J. Hartman
- Herbert Wertheim School of Public HealthUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Derek Lomas
- Faculty of Industrial Design EngineeringUniversity of DelftDelftThe Netherlands
| | - Howard H. Feldman
- Department of NeurosciencesUniversity of California San DiegoSan DiegoCaliforniaUSA
- Alzheimer's Disease Cooperative StudyUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Sarah J. Banks
- Department of NeurosciencesUniversity of California San DiegoSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
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Gjøra L, Strand BH, Bergh S, Bosnes I, Johannessen A, Livingston G, Skjellegrind HK, Selbæk G. Prevalence and Determinants of Diagnosed Dementia: A Registry Linkage Study Linking Diagnosis of Dementia in the Population-Based HUNT Study to Registry Diagnosis of Dementia in Primary Care and Hospitals in Norway. J Alzheimers Dis 2024; 99:363-375. [PMID: 38701153 DOI: 10.3233/jad-240037] [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: 05/05/2024]
Abstract
Background A timely diagnosis of dementia can be beneficial for providing good support, treatment, and care, but the diagnostic rate remains unknown and is probably low. Objective To determine the dementia diagnostic rate and to describe factors associated with diagnosed dementia. Methods This registry linkage study linked information on research-based study diagnoses of all-cause dementia and subtypes of dementias, Alzheimer's disease, and related dementias, in 1,525 participants from a cross-sectional population-based study (HUNT4 70+) to dementia registry diagnoses in both primary-care and hospital registries. Factors associated with dementia were analyzed with multiple logistic regression. Results Among those with research-based dementia study diagnoses in HUNT4 70+, 35.6% had a dementia registry diagnosis in the health registries. The diagnostic rate in registry diagnoses was 19.8% among home-dwellers and 66.0% among nursing home residents. Of those with a study diagnosis of Alzheimer's disease, 35.8% (95% confidence interval (CI) 32.6-39.0) had a registry diagnosis; for those with a study diagnosis of vascular dementia, the rate was 25.8% (95% CI 19.2-33.3) and for Lewy body dementias and frontotemporal dementia, the diagnosis rate was 63.0% (95% CI 48.7-75.7) and 60.0% (95% CI 43.3-75.1), respectively. Factors associated with having a registry diagnosis included dementia in the family, not being in the youngest or oldest age group, higher education, more severe cognitive decline, and greater need for help with activities of daily living. Conclusions Undiagnosed dementia is common, as only one-third of those with dementia are diagnosed. Diagnoses appear to be made at a late stage of dementia.
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Affiliation(s)
- Linda Gjøra
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bjørn Heine Strand
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Department of Physical Health and Ageing, Norwegian institute of Public Health, Oslo, Norway
| | - Sverre Bergh
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Ingunn Bosnes
- Department of Psychiatry, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway
| | - Aud Johannessen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Håvard Kjesbu Skjellegrind
- Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Geir Selbæk
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Siette J, Meka A, Antoniades J. Breaking the barriers: overcoming dementia-related stigma in minority communities. Front Psychiatry 2023; 14:1278944. [PMID: 38179250 PMCID: PMC10765564 DOI: 10.3389/fpsyt.2023.1278944] [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: 08/17/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Dementia is a global health concern that affects individuals irrespective of their cultural or linguistic backgrounds. However, research has long recognized the pronounced stigma associated with dementia, particularly within Culturally and Linguistically Diverse (CALD) communities. This article seeks to summarize the underlying factors contributing to the heightened levels of dementia stigma within CALD communities, through a review of the literature. Our examination shows that cultural beliefs, language barriers, limited awareness, and the impact of migration on perceptions of aging and cognitive decline are contributing factors. Consequently, our analysis highlights the need for tailored, culturally appropriate interventions aimed at mitigating stigma and enhancing dementia care within CALD populations. Our proposed solutions, built on a social-ecological approach, highlights the critical role of collaborative efforts involving policymakers, healthcare providers, community organizations, and CALD community members in fostering a more dementia-inclusive society. This perspective piece aims to shed light on the distinct challenges faced by CALD communities, while advocating for a holistic approach to redefine perceptions and care strategies tailored to these populations.
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Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
- Australian Institute for Health Innovation, Macquarie University, Macquarie Park, NSW, Australia
| | - Anjani Meka
- Australian Institute for Health Innovation, Macquarie University, Macquarie Park, NSW, Australia
| | - Josefine Antoniades
- National Ageing Research Institute, Affiliate Global and Women’s Health, School of Public Health and Preventive Medicine, Monash University, Royal Melbourne Hospital, Parkville, VIC, Australia
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Wang N, Xu H, West JS, Østbye T, Wu B, Xian Y, Dupre ME. Association between perceived risk of Alzheimer's disease and related dementias and cognitive function among U.S. older adults. Arch Gerontol Geriatr 2023; 115:105126. [PMID: 37494832 PMCID: PMC10615679 DOI: 10.1016/j.archger.2023.105126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION The aim of the study was to assess factors associated with the perceived risk of developing Alzheimer's disease and related dementias (ADRD) and how the perceived risk of ADRD was related to cognitive function. METHODS We conducted a retrospective cohort study using 5 waves of data from the Health and Retirement Study (2012-2022) that included adults aged 65 years or older with no previous diagnosis of ADRD at baseline. Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7's test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range = 0-35). Perceived risk of developing ADRD was categorized at baseline as "definitely not" (0% probability), "unlikely" (1-49%), "uncertain" (50%), and "more than likely" (>50-100%). Additional baseline measures included participants' sociodemographic background, psychosocial resources, health behaviors, physiological status, and healthcare utilization. RESULTS Of 1457 respondents (median age 74 [IQR = 69-80] and 59.8% women), individuals who perceived that they were "more than likely" to develop ADRD had more depressive symptoms and were more likely to be hospitalized in the past two years than individuals who indicated that it was "unlikely" they would develop ADRD. Alternatively, respondnets who perceived that they would "definitely not" develop ADRD were more likely to be non-Hispanic Black, less educated, and have lower income than individuals who indicated it was "unlikely" they would develop ADRD. Respondents who reported their risks of developing ADRD as "more than likely" (β = -2.10, P < 0.001) and "definitely not" (β = -1.50, P < 0.001) had the lowest levels of cognitive function; and the associations were explained in part by their socioeconomic, psychosocial, and health status. CONCLUSIONS Perceived risk of developing ADRD is associated with cognitive function. The (dis)concordance between individuals' perceived risk of ADRD and their cognitive function has important implications for increasing public awareness and developing interventions to prevent ADRD.
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Affiliation(s)
- Nan Wang
- Department of Public Health Sciences, School of Medicine, UC-Davis, CA, United States of America
| | - Hanzhang Xu
- Department of Family Medicine and Community Health, Duke University, Durham, NC, United States of America; Duke University School of Nursing, Duke University, Durham, NC, United States of America; Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States of America.
| | - Jessica S West
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States of America; Department of Population Health Sciences, Duke University, Durham, NC, United States of America
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University, Durham, NC, United States of America; Duke University School of Nursing, Duke University, Durham, NC, United States of America; Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States of America
| | - Bei Wu
- NYU Rory Meyers College of Nursing, New York, NY, United States of America
| | - Ying Xian
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Matthew E Dupre
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States of America; Department of Population Health Sciences, Duke University, Durham, NC, United States of America; Department of Sociology, Duke University, Durham, NC, United States of America
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Siette J, Dodds L, Catanzaro M, Allen S. To be or not to be: Arts-based approaches in public health messaging for dementia awareness and prevention. Australas J Ageing 2023; 42:769-779. [PMID: 37641976 DOI: 10.1111/ajag.13235] [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: 02/09/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVES Multiple modifiable risk factors exist across the lifespan to reduce dementia prevalence, and public understanding of these factors is increasing. Yet dementia is frequently misunderstood and stigmatised, and dementia prevention is not generally recognised as a health priority. Current limitations of public health campaigns for dementia prevention must be addressed and innovative alternatives developed to improve public comprehension and implementation of preventative action across all stages of life. METHODS In searching various databases and public information on dementia prevention, restraints were found in current health messaging which did not reflect the complexity of this health issue and address diversity of its impact across cultures and ages. In consultation with researchers and public health organisations, we outline four case studies in Australia where innovative arts-based approaches have been adopted and discuss the potential for arts-based approaches to address these gaps. RESULTS Arts-based approaches have the unique capacity to shift perceptions on ageing and dementia, overcome language and literacy barriers, represent health concerns across cultures, and actively involve individuals, communities and healthcare professionals in the process of dementia prevention. Future campaigns can engage a variety of communities and environments with art mediums suited to their preferences, capacities and efficacy. CONCLUSIONS Recommendations include example mediums, environments and people to engage. Future research is required to understand the impact of, and to improve, the long-term adoption of innovative arts-based approaches in dementia prevention practices.
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Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, New South Wales, Australia
- The Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Laura Dodds
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, New South Wales, Australia
| | - Michelle Catanzaro
- Design, School of Humanities and Communication Arts, Western Sydney University, Penrith, New South Wales, Australia
| | - Sayler Allen
- ANU School of Sociology, The Australian National University, Canberra, Australian Capital Territory, Australia
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Mohamad RM, Alsaeed MSA, Merdad AH, Alghaith DM, Binnshwan FM, Albusaad RA, Almuslem MY, Alamri RA, Hussan Awaji HH, Alqahtani MN, Alamrani AA. Evaluating the General Population of Saudi Arabia for Their Knowledge, Attitudes, and Practices Towards Dementia. Cureus 2023; 15:e49865. [PMID: 38170079 PMCID: PMC10760348 DOI: 10.7759/cureus.49865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Dementia, a prevalent neurological condition, has a significant global impact on individuals and communities. Despite affecting approximately 50 million people worldwide, with an expected tripling by 2050, there are currently no widely available disease-modifying treatments. Recent efforts have concentrated on strategies involving legislation, regulations, and population-wide initiatives to address dementia risk, diagnosis, and care. Methods This cross-sectional survey engaged 6123 participants in Saudi Arabia, utilizing a multistage sampling design across provinces and cities. The study aimed to investigate the knowledge, attitudes, and practices of the Saudi Arabian general population regarding dementia. Results Participants displayed diverse opinions on dementia knowledge, with females exhibiting higher rates of knowledge, attitudes, and practices than males. Notably, 97.2% of females were aware of dementia compared to 78% of males. The perception of dementia as a healthcare priority was significantly higher in females (84.1%) than in males (59.6%). Older females (≥65) were identified as the age group most associated with dementia (92.50%) compared to males (71.10%). Conclusion While participants demonstrated excellent knowledge of hearing about dementia, understanding symptoms, and identifying modifiable factors, their knowledge regarding prevention and curability was found to be inadequate. A significant gender association was observed, with females exhibiting higher knowledge, attitudes, and practices than males.
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Affiliation(s)
- Rofayda M Mohamad
- Department of Preventive Medicine, King Salman Armed Forces Hospital in Northwestern Region, Tabuk, SAU
| | | | - Abdulrahman H Merdad
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Deemah M Alghaith
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Zülke AE, Luppa M, van Boxtel M, Deckers K, Heger I, Köhler S, Riedel-Heller SG. Older adults' awareness of modifiable risk and protective factors for dementia and interest in eHealth interventions for brain health: a comparison between the Netherlands and Germany. BMC Public Health 2023; 23:2321. [PMID: 37996822 PMCID: PMC10668348 DOI: 10.1186/s12889-023-17247-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Evidence on modifiable risk factors for dementia is accumulating rapidly, including e.g. smoking, hypertension, and diabetes. Comparing knowledge of risk factors for dementia and factors associated with knowledge and motivation to learn about dementia risk reduction in different countries may support the design of tailored public health campaigns. We investigated (1) differences in knowledge of risk and protective factors for dementia between the Netherlands and Germany, and interest in (2) information on brain health and (3) eHealth for brain health. MATERIALS AND METHODS Population-based telephone (Germany) or web-based surveys (Netherlands) were conducted among adults aged 60-75 (ntotal=614; Germany: n = 270; Netherlands: n = 344), assessing sociodemographic factors, knowledge of risk and protective factors for dementia, interest in information on brain health and respective eHealth-tools. Correlates of knowledge, interest in information on brain health and eHealth for brain health were analyzed using multivariable regression, by country and in pooled analyses. RESULTS In the total sample (Mage: 67.3 (SD: 4.3) years; %female: 48.6), knowledge of risk and protective factors (sum score assessing number of correctly identified factors) was higher among German participants (M (SD) = 7.6 (2.5) vs. 6.0 (4.3), p < .001). This was confirmed using linear regression analyses, controlling for sociodemographic covariates (b = 1.51; 95% CI: 1.00; 2.01). High education was linked to better knowledge of risk and protective factors (b = 1.61; 95% CI: 0.89; 2.34). Controlling for covariates, interest in information on brain health (OR: 0.05, 95% CI: 0.02; 0.09) and eHealth for brain health (OR: 0.40, 95% CI: 0.25; 0.65) was lower in German participants. Widowed participants were less interested in information on brain health, while widowed and single participants expressed less interest in eHealth for brain health in pooled analyses. Further associations between sociodemographic factors, interest in information on brain health and eHealth for brain health by country were detected. DISCUSSION Engaging older adults in the design of eHealth interventions and cooperation with trusted sources, e.g., general practitioners, might enhance appreciation of eHealth for brain health. Education on risk and protective factors for dementia is warranted in both countries. However, differences in recruitment and assessment need to be acknowledged.
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Affiliation(s)
- Andrea E Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Irene Heger
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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Jeon YH, Krein L, O’Connor CMC, Mowszowski L, Duffy S, Seeher K, Rauch A. A Systematic Review of Quality Dementia Clinical Guidelines for the Development of WHO's Package of Interventions for Rehabilitation. THE GERONTOLOGIST 2023; 63:1536-1555. [PMID: 36043424 PMCID: PMC10581378 DOI: 10.1093/geront/gnac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As part of the WHO Rehabilitation 2030 call for action, the WHO Rehabilitation Programme is developing its Package of Interventions for Rehabilitation (PIR) to support ministries of health around the globe in integrating rehabilitation services into health systems. As a vital step for this PIR development, we conducted a systematic review of clinical practice guidelines (CPGs) for dementia to identify interventions for rehabilitation and related evidence. RESEARCH DESIGN AND METHODS Following WHO Rehabilitation Programme and Cochrane Rehabilitation's methodology, quality CPGs published in English between January 2010 and March 2020 were identified using PubMed, Embase, CINAHL, PEDro, Google Scholar, guideline databases, and professional society websites. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (II). RESULTS Of the 22 CPGs that met the selection criteria, 6 satisfied the quality evaluation. Three hundred and thirty rehabilitation-related recommendations were identified, mostly concentrated in the areas of cognition, emotion, and carer support. There were many strong interventions, with moderate- to high-quality evidence that could be easily introduced in routine practice. However, major limitations were found both in the quality of evidence and scope, especially in areas such as education and vocation, community and social life, and lifestyle modifications. DISCUSSION AND IMPLICATIONS Further rigorous research is needed to build quality evidence in dementia rehabilitation in general, and especially in neglected areas for rehabilitation. Future work should also focus on the development of CPGs for dementia rehabilitation. A multipronged approach is needed to achieve Universal Health Coverage for dementia rehabilitation.
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Affiliation(s)
- Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Luisa Krein
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Claire M C O’Connor
- Centre for Positive Ageing, HammondCare, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Loren Mowszowski
- Brain and Mind Centre & School of Psychology, The University of Sydney, Sydney, Australia
| | - Shantel Duffy
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Katrin Seeher
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Alexandra Rauch
- Rehabilitation Programme, World Health Organization, Geneva, Switzerland
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Azar M, Chapman S, Joyce J, Schultheis M, Zhang Z, Waltrip L, Shagalow S, Zeiger P, Sunderaraman P, Cosentino S. Education as a Moderator of Help Seeking Behavior in Subjective Cognitive Decline. Alzheimer Dis Assoc Disord 2023; 37:184-188. [PMID: 37561937 PMCID: PMC10530107 DOI: 10.1097/wad.0000000000000571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Disparities in Alzheimer disease (AD) and differences in help seeking (HS) across sociodemographic groups warrant public health concern. Research addressing such disparities must shift toward the earliest clinical manifestations of AD to optimize diagnosis, intervention and care planning. Subjective cognitive decline (SCD), a risk state for AD, provides an important context in which to examine sociodemographic-related disparities in HS. PARTICIPANTS AND METHODS One hundred sixty-seven cognitively healthy older adults (M age =73, M education =16) (26.4% Black, Asian, or "Other") completed SCD questionnaire, HS questions, and mood measures (depression and anxiety). Binary logistic adjusted regressions examined: (a) the association between SCD and HS; and (b) the extent to which education moderated the relationship between SCD and HS. SCD [b = 0.06, SE=0.13, P <0.001, odds ratio=1.06, 95% CI (1.03, 1.08)] and education [b=0.32, SE=0.09, P <0.001, odds ratio=1.37, 95% CI (1.15, 1.64)] were independently associated with HS, with significant interaction between education and SCD on HS [b=0.2, SE=0.01, P =0.01, odds ratio=1.02, 95% CI (1.00, 1.03)]. CONCLUSIONS Findings elucidate the importance of tailoring SCD-related psychoeducational resources depending on educational background as a preliminary stepping-stone in encouraging HS among older adults who may be at particular risk for developing dementia.
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Affiliation(s)
- Martina Azar
- Psychology Department, VA Boston Healthcare System, Boston, MA, USA
| | - Silvia Chapman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Jillian Joyce
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Maria Schultheis
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Zoe Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Leah Waltrip
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Shaina Shagalow
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Peter Zeiger
- Vagelos College of Physicians and Surgeons, Columbia University, NY, NY, USA
| | | | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
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Daube D, Wiedicke A, Reifegerste D, Rossmann C. Who is Responsible? Attribution of Responsibility in the Context of Dementia: A Content-Analysis of Framing in Media Coverage. JOURNAL OF HEALTH COMMUNICATION 2023; 28:273-281. [PMID: 37038766 DOI: 10.1080/10810730.2023.2199684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Dementia is currently one of the most significant public health challenges from a medical as well as a societal perspective. The number of people living with dementia is increasing, and there is conflicting evidence in terms of preventive measures and risk factors. The available therapies can slow down but neither stop nor reverse the condition. Educating the public about these circumstances is thus of utmost relevance. As the mass media are a major source of health-related information, this study uses a quantitative content analysis to examine the extent to which responsibility framing occurs concerning risk and protection factors for dementia. Besides the established levels of individual and society, this study considers the level "social network" as an independent level to account for the supporting role of relatives and friends in the care of people living with dementia. The results show that protection factors for dementia are reported more frequently than the risk factors of the condition. Further, attribution of responsibility for risk factors tended to be at the individual level, while protection was the responsibility of society and the social network.
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Affiliation(s)
- Dominik Daube
- Institute of Communication Science, Friedrich Schiller University, Jena, Germany
| | - A Wiedicke
- Department of Media and Communication, Ludwig Maximilians University, Munich, Germany
| | - D Reifegerste
- School of Public Health, University of Bielefeld, Bielefeld, Germany
| | - C Rossmann
- Department of Media and Communication, Ludwig Maximilians University, Munich, Germany
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Zülke A, Luppa M, Köhler S, Riedel-Heller SG. [What does the population know about risk and protective factors for dementia? An international review of the current state of knowledge in various countries]. DER NERVENARZT 2023; 94:384-391. [PMID: 37099170 DOI: 10.1007/s00115-023-01471-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND The scientific state of knowledge on modifiable risk factors for dementia has greatly improved in recent years. The established risk and protective factors include physical and social inactivity, hypertension, diabetes mellitus, excessive alcohol consumption and smoking; however, it is assumed that this knowledge is so far insufficiently disseminated among the general population, indicating untapped potential for primary prevention of dementia. OBJECTIVE To assess the state of knowledge on established risk and protective factors for dementia in the general population. MATERIAL AND METHODS Based on a systematic literature search in the PubMed database, international studies that investigated the knowledge on modifiable risk and/or protective factors for dementia in samples from the general population were identified. RESULTS AND CONCLUSION A total of 21 publications were included in the review. The majority of publications (n = 17) collated risk and protective factors using closed questions, while n = 4 studies used open questions. Lifestyle factors, e.g. cognitive, social and physical activity, were most frequently named as protective against dementia. Furthermore, many participants recognized depression as a risk factor for dementia. Knowledge of cardiovascular risk constellations for dementia, such as hypertension, hypercholesterolemia or diabetes mellitus were much less known among the participants. The results indicate that there is a need for a targeted clarification of the role of pre-existing cardiovascular diseases as risk factors for dementia. Studies assessing the state of knowledge on social and environmental risk and protective factors for dementia are currently scarce.
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Affiliation(s)
- Andrea Zülke
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
| | - Melanie Luppa
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Niederlande
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
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Lee SE, Hong M, Casado BL. Alzheimer's disease (AD) knowledge in Korean Americans: identifying knowledge gaps and misconceptions and examining predictors of AD knowledge. ETHNICITY & HEALTH 2023; 28:431-445. [PMID: 35229696 DOI: 10.1080/13557858.2022.2045907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES This study examined Alzheimer's disease (AD) knowledge and its predictors among Korean Americans (KAs). DESIGN Convenience sampling was used to recruit KAs in the Greater Washington metropolitan area. A total of 268 KAs participated in the study and completed a cross-sectional survey in 2014. Using the Alzheimer's Disease Knowledge Scale (ADKS), overall and domain knowledge was assessed. Multiple regression analyses were conducted for overall and domain knowledge with predictors including exposure to AD, social engagement, sources and frequency of health-related information, stigmatic beliefs (pity, antipathy, and social distance), English proficiency, and education. RESULTS KAs reported a 59% accuracy in the overall AD knowledge. At the domain level, KAs were most knowledgeable about assessment and diagnosis and least knowledgeable about caregiving. Our regression analyses showed that having a college degree or higher is associated with a greater overall AD knowledge. Three domain models of life impact, risk factors, and caregiving turned out to be significant: Having a college degree or higher is a predictor of greater knowledge in all three domains. Having more pity stigmatic beliefs is related to greater knowledge in both life impact and caregiving domains while having less pity stigmatic beliefs is associated with more risk factor knowledge; having less social distance stigmatic beliefs is associated with greater life impact knowledge; and having less antipathy stigmatic beliefs is related to better caregiving knowledge. CONCLUSION Our findings revealed areas of misconceptions and knowledge gaps in KAs which need to be addressed in educational interventions. Different knowledge status across the domains demonstrates a multi-dimensional nature of AD knowledge. Multivariate findings confirmed the robust role of education in overall and domain AD knowledge. The effect of different AD stigmatic beliefs on certain AD knowledge domains suggests ways of how stigma change can be efficient for the purpose of increasing AD domain knowledge in KAs.
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Affiliation(s)
- Sang E Lee
- School of Social Work, San Jose State University, San Jose, CA, USA
| | - Michin Hong
- School of Social Work, Indiana University, Indianapolis, IN, USA
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Zeyen P, Sannemann L, Bohr L, Escher C, Müller T, Ramírez A, Rostamzadeh A, Jessen F. [Brain health services: individual dementia risk profiling at the Cologne Alzheimer Prevention Center]. DER NERVENARZT 2023; 94:392-399. [PMID: 36881112 DOI: 10.1007/s00115-023-01451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND According to current knowledge approximately 30-40% of all cases of dementia can be attributed to modifiable risk factors. As a result, dementia prevention and the concept of brain health are becoming increasingly relevant. RESEARCH QUESTION The requirements for brain health services and their implementation are discussed and the Cologne Alzheimer Prevention Center (KAP) of the University Hospital Cologne is described as an example. MATERIAL AND METHODS In addition to a report on international brain health initiatives, the main activities of the KAP are presented. A program for individual risk profiling and risk communication is provided, which was piloted in the KAP in the context of the "Individual risk profiling for Alzheimer's disease and dementia prevention (INSPIRATION)" study. The prevalence of risk factors in a cognitively healthy sample aged 50-86 years (n = 162) with interest in dementia prevention is presented. RESULTS The most common risk factors were non-Mediterranean diet, obesity, subjective poor sleep quality and increased stress. Based on these results, preventive interventions can be developed that are adapted to the individual risk profile as a personalized medicine approach. DISCUSSION Structures such as the KAP can provide individual risk factor assessment and personalized dementia prevention. The efficacy of this approach on dementia risk reduction needs to be evaluated.
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Affiliation(s)
- Philip Zeyen
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Lena Sannemann
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Lara Bohr
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Claus Escher
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn, Bonn, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn/Köln, Bonn, Deutschland
| | - Theresa Müller
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Köln, Deutschland
| | - Alfredo Ramírez
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn, Bonn, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn/Köln, Bonn, Deutschland.,Medizinische Fakultät und Uniklinik Köln, Cluster of Excellence Cellular Stress Responses in Aging-associated Diseases (CECAD), Universität zu Köln, Köln, Deutschland
| | - Ayda Rostamzadeh
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Frank Jessen
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn/Köln, Bonn, Deutschland.,Medizinische Fakultät und Uniklinik Köln, Cluster of Excellence Cellular Stress Responses in Aging-associated Diseases (CECAD), Universität zu Köln, Köln, Deutschland
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Paul P, Mahfoud ZR, Malik RA, Kaul R, Muffuh Navti P, Al-Sheikhly D, Chaari A. Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer's Disease and Dementia in Qatar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4535. [PMID: 36901551 PMCID: PMC10002196 DOI: 10.3390/ijerph20054535] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Dementia is characterized by progressive cognitive decline, memory impairment, and disability. Alzheimer's disease (AD) accounts for 60-70% of cases, followed by vascular and mixed dementia. Qatar and the Middle East are at increased risk owing to aging populations and high prevalence of vascular risk factors. Appropriate levels of knowledge, attitudes, and awareness amongst health care professionals (HCPs) are the need of the hour, but literature indicates that these proficiencies may be inadequate, outdated, or markedly heterogenous. In addition to a review of published quantitative surveys investigating similar questions in the Middle East, a pilot cross-sectional online needs-assessment survey was undertaken to gauge these parameters of dementia and AD among healthcare stakeholders in Qatar between 19 April and 16 May 2022. Overall, 229 responses were recorded between physicians (21%), nurses (21%), and medical students (25%), with two-thirds from Qatar. Over half the respondents reported that >10% of their patients were elderly (>60 years). Over 25% reported having contact with >50 patients with dementia or neurodegenerative disease annually. Over 70% had not undertake related education/training in the last 2 years. The knowledge of HCPs regarding dementia and AD was moderate (mean score of 5.3 ± 1.5 out of 7) and their awareness of recent advances in basic disease pathophysiology was lacking. Differences existed across professions and location of respondents. Our findings lay the groundwork for a call-to-action for healthcare institutions to improve dementia care within Qatar and the Middle East region.
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Affiliation(s)
| | - Ziyad Riyad Mahfoud
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, NY 10065, New York, USA
| | - Rayaz A. Malik
- Division of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, UK
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | | | - Phyllis Muffuh Navti
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Deema Al-Sheikhly
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Ali Chaari
- Premedical Division, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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43
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Mansfield E, Watson R, Carey M, Sanson‐Fisher R. Perceptions of community members in Australia about the risk factors, symptoms and impacts of dementia: A cross-sectional questionnaire study. Australas J Ageing 2023; 42:140-148. [PMID: 35848531 PMCID: PMC10947370 DOI: 10.1111/ajag.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/04/2022] [Accepted: 05/08/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Ensuring that the Australian public has an accurate understanding of the characteristics of dementia may assist in improving timely detection of dementia. This cross-sectional questionnaire study aimed to examine community members' perceptions of the risk factors, symptoms and impacts of dementia. METHODS Participants were recruited from outpatient units at a major regional hospital and were aged at least 18 years, a patient or an accompanying support person, did not have a dementia diagnosis, had sufficient English knowledge and were well enough to complete a survey. Participants completed a web-based survey on a touchscreen computer including items exploring knowledge of dementia risk factors, symptoms and perceived impacts if they or a loved one had dementia. Counts and proportions were calculated and perceived impacts of dementia were compared for self versus loved one using a χ2 test. RESULTS Of 353 eligible individuals approached, 208 consented and were included in the study. Between 30% and 61% (n = 62-127) of participants believed modifiable factors such as high alcohol consumption and high blood pressure were associated with increased risk of dementia. While a majority of participants (87-96%; n = 164-181) identified memory-related symptoms, less than one-third recognised behavioural symptoms. Participants were more likely to identify emotional and practical impacts compared to physical or social impacts as most difficult if they or a loved one had dementia. CONCLUSIONS There remains a need for increased community education to address knowledge gaps regarding modifiable risk factors, behavioural symptoms and potential impacts of dementia on the individual diagnosed and their carers.
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Affiliation(s)
- Elise Mansfield
- Health Behaviour Research CollaborativeUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Rochelle Watson
- Health Behaviour Research CollaborativeUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Mariko Carey
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Rob Sanson‐Fisher
- Health Behaviour Research CollaborativeUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
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Welberry HJ, Chau T, Heffernan M, San Jose JC, Jorm LR, Singh MF, Sachdev PS, Anstey KJ, Lautenschlager NT, Valenzuela M, McNeil J, Brodaty H. Factors Associated with Participation in a Multidomain Web-Based Dementia Prevention Trial: Evidence from Maintain Your Brain (MYB). J Alzheimers Dis 2023; 92:959-974. [PMID: 36806506 DOI: 10.3233/jad-220990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND The Maintain Your Brain (MYB) trial aims to prevent cognitive decline and dementia through multidomain, web-based risk-reduction. To facilitate translation, it is important to understand drivers of participation. OBJECTIVE To describe characteristics associated with participation in MYB. METHODS This was an observational ancillary study of MYB, a randomized controlled trial nested within the 45 and Up Study in New South Wales, Australia. We linked 45 and Up Study survey and MYB participation data. The study cohort comprised 45 and Up Study participants, aged 55-77 years at 1 January 2018, who were invited to participate in MYB. 45 and Up Study participant characteristics and subsequent MYB consent and participation were examined. RESULTS Of 98,836 invited, 13,882 (14%) consented to participate and 6,190 participated (6%). Adjusting for age and sex, a wide range of factors were related to participation. Higher educational attainment had the strongest relationship with increased MYB participation (university versus school non-completion; AdjOR = 5.15; 95% CI:4.70-5.64) and lower self-rated quality of life with reduced participation (Poor versus Excellent: AdjOR = 0.19; 95% CI:0.11-0.32). A family history of Alzheimer's disease was related to increased participation but most other dementia risk factors such as diabetes, obesity, stroke, high blood pressure, and current smoking were associated with reduced participation. CONCLUSION Higher socio-economic status, particularly educational attainment, is strongly associated with engagement in online dementia prevention research. Increasing population awareness of dementia risk factors, and better understanding the participation barriers in at-risk groups, is necessary to ensure online interventions are optimally designed to promote maximum participation.
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Affiliation(s)
- Heidi J Welberry
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tiffany Chau
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Megan Heffernan
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Juan Carlo San Jose
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Louisa R Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Maria Fiaratone Singh
- School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia.,School of Psychology, University of New South Wales, Sydney, Australia.,Neuroscience Research Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Australia.,North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Michael Valenzuela
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
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Dukelow T, Lawrence EG, Jacobson L, Vassilev P, Koychev I, Muhammed K, Kennelly SP. Modifiable risk factors for dementia, and awareness of brain health behaviors: Results from the Five Lives Brain Health Ireland Survey (FLBHIS). Front Psychol 2023; 13:1070259. [PMID: 36710802 PMCID: PMC9879702 DOI: 10.3389/fpsyg.2022.1070259] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/13/2022] [Indexed: 01/13/2023] Open
Abstract
Up to 40% of dementias globally are attributable to modifiable risk factors. Many existing studies examining attitudes to brain health are limited by a failure to consider a range of pertinent risk factors and associated barriers to protective behaviors. In Ireland, self-reported knowledge of dementia is poor compared to other conditions. In this context, the current study aimed to explore exposure to and awareness of specific modifiable risk factors for dementia. We also aimed to investigate whether exposure to these risk factors is associated with demographic and socioeconomic factors. A cross-sectional survey was administered to 555 voluntary participants in February 2022. The survey captured the following information: (1) Sociodemographic factors; (2) Exposure to, as well as knowledge of modifiable risk factors for dementia, namely diet, social interaction, exercise, hypertension, sleep, depression, smoking, alcohol consumption, cognitive stimulation, hearing impairment, diabetes, air pollution, and head injury. The study population comprised 551 participants (50.3% male; 49.6% female). Mean age was 59.7 years. Modifiable risk factors for dementia were prevalent. Relative to females, male gender was significantly associated with multiple risk factors. Whilst 65.6% of participants believed that lifestyle improvements can decrease a person's risk of developing dementia, only 31.4% believed that dementia could be prevented. Head injury (90.9%, n = 500), low mental stimulation (85.3%, n = 469), and alcohol consumption (77.8%, n = 428) were the three most commonly recognized risk factors. Awareness was significantly greater in both university groups (undergraduate and postgraduate) for multiple risk factors. Our findings demonstrate that the distribution of exposure to modifiable risk factors for dementia is unequal across gender and age groups, and that awareness levels vary across risk factors. These findings highlight that focus surrounding dementia prevention should shift toward individual risk profiling and should be tailored toward an individual's specific needs.
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Affiliation(s)
- Tim Dukelow
- Cork University Hospital (CUH), Cork, Ireland
| | - Erin Grace Lawrence
- Unit of Psychological Medicine, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- Five Lives SAS, Tours, France
| | | | | | - Ivan Koychev
- Five Lives SAS, Tours, France
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Kinan Muhammed
- Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Sean P. Kennelly
- Tallaght University Hospital, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
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46
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Kenne Malaha A, Thébaut C, Achille D, Preux PM, Guerchet M. Costs of Dementia in Low- And Middle-Income Countries: A Systematic Review. J Alzheimers Dis 2023; 91:115-128. [PMID: 36404540 DOI: 10.3233/jad-220239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The proportion of people living with dementia in low- and middle-income countries (LMICs) is expected to reach 71% by 2050. Appraising the economic burden of the disease may contribute to strategic policy planning. OBJECTIVE To review studies conducted on the costs of dementia in LMICs, describe their methodology and summarize available costs estimates. METHODS Systematic review, including a search of health, economics, and social science bibliographic databases. No date or language restrictions were applied. All studies with a direct measure of the costs of dementia care were included. RESULTS Of the 6,843 publications reviewed, 17 studies from 11 LMICs were included. Costs of dementia tended to increase with the severity of the disease. Medical costs were greater in the mild stage, while social and informal care costs were highest in the moderate and severe stages. Annual cost estimates per patient ranged from PPP$131.0 to PPP$31,188.8 for medical costs; from PPP$16.1 to PPP$10,581.7 for social care services and from PPP$140.0 to PPP$25,798 for informal care. Overall, dementia care can cost from PPP$479.0 to PPP$66,143.6 per year for a single patient. CONCLUSION Few studies have been conducted on the costs of dementia in LMICs, and none so far in Africa. There seems to be a need to provide accurate data on the burden of disease in these countries to guide public health policies in the coming decades.
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Affiliation(s)
- Angeladine Kenne Malaha
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France
| | - Clémence Thébaut
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France.,Leda-Legos, PSL Research University, Paris Dauphine University, Paris, France
| | - Dayna Achille
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France.,CHU, Centre d'Epidémiologie de Biostatistiqueet de Méthodologie de la Recherche, Limoges, France
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France
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47
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Zülke AE, Luppa M, Luck T, Riedel-Heller SG. Short report: A trend analysis of attitudes towards early diagnosis of dementia in Germany. PLoS One 2023; 18:e0272896. [PMID: 37093802 PMCID: PMC10124858 DOI: 10.1371/journal.pone.0272896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 04/11/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Early detection of dementia provides numerous benefits for those living with dementia and their relatives and healthcare systems at large. Methods available for early diagnosis have improved significantly over the past years. Therefore, we examined whether support for offering an early diagnosis of dementia and willingness to pursue a respective early diagnosis have changed in Germany over the last decade. METHOD We compared findings from two representative telephone surveys conducted among older adults in Germany (≥ 60 years of age) in 2011 and 2022, assessing support for offering an early diagnosis of dementia and willingness to pursue a respective early diagnosis in a sample of n = 879 individuals (mean age: 72.9, range: 60-98 years, % female: 58.8). Group comparisons using Chi2- and t-tests and multivariable regression analyses were conducted, regressing support of an early diagnosis of dementia and willingness to pursue a respective early diagnosis on age, gender, education, employment status, belief in preventability of dementia and time of survey. RESULTS Support for offering an early diagnosis of dementia was high both in 2011 (90.7%) and 2022 (79.2%), but declined over time (OR: .39; 95% CI: .25; .63). Willingness to pursue an early diagnosis of dementia declined from 70.7% to 60.1% in the same period (OR: .62; 95% CI: .45; .86). Belief in preventability of dementia was linked to support for offering an early diagnosis (OR: 1.88, 95% CI: 1.25; 2.83) and willingness to pursue an early diagnosis of dementia (OR: 1.52; 95% CI: 1.12; 2.07). Older participants less often supported offering an early diagnosis of dementia (OR: .97, 95% CI: .95; .99). CONCLUSION Support for offering an early diagnosis of dementia and willingness to pursue a respective diagnosis is high in the older German public, but lower than reported previously. Improving knowledge on modifiable risk factors and better understanding of individual motives underlying endorsement or refusal of an early diagnosis may increase acceptance in the general public.
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Affiliation(s)
- Andrea E Zülke
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Tobias Luck
- Faculty of Applied Social Sciences, University of Applied Sciences Erfurt, Erfurt, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
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48
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Abdalrahim A, Alamoush KM, ALBashtawy M, Hamaideh SH, Mohammad KI, Alkhawaldeh A, Alazzam M, Alhroub N, Suliman M, ALBashtawy B. Jordanian Community People's Knowledge of and Attitudes Toward Dementia. SAGE Open Nurs 2023; 9:23779608231201052. [PMID: 37705733 PMCID: PMC10496485 DOI: 10.1177/23779608231201052] [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: 03/28/2023] [Revised: 07/13/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction Limited research exists on the knowledge and attitudes of Jordanian community residents toward people with dementia (PwD). As the prevalence of dementia is anticipated to increase, there is a critical need for informed knowledge and positive attitudes toward dementia in the Jordanian community. Objectives This study aimed to evaluate people's knowledge of and attitudes toward PwD and identify the predictors of dementia knowledge and attitudes. Methods The study employed a cross-sectional research design and utilized a self-administered questionnaire as the primary data collection method. The study employed the Alzheimer's Disease Knowledge Scale (ADKS) to evaluate the knowledge of the participants, and the Dementia Attitudes Scale (DAS) was utilized to assess their attitudes in the Jordanian community. Multiple regression analysis was performed to find relevant factors influencing knowledge of and attitude toward dementia. Results The study's 346 participants revealed limited knowledge about dementia, with an average ADKS score of 17.21 out of 30. However, participants showed a positive attitude toward dementia, as evidenced by a mean DAS score of 88 out of 140. Statistical analysis demonstrated significantly higher knowledge scores among employed individuals (P < .05), while females exhibited significantly higher attitude scores (P < .05). Participants with experience in geriatric clinical practice, dementia education or training, informal caregiving experience, and a desire to learn more about dementia also exhibited significantly higher knowledge and attitude scores (P < .05). Conclusion The study offers preliminary insights into the knowledge and attitudes toward dementia in the Jordanian population. The findings underscore the importance of continuing education and training to increase knowledge and understanding of dementia. Improving dementia care and support in Jordan requires enhancing knowledge and attitudes toward dementia. The study findings were presented to policymakers, with recommendations for strategic planning and the development of awareness programs. Future research can build upon these findings and promote evidence-based practices in dementia care and community awareness programs.
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Affiliation(s)
- Asem Abdalrahim
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | | | - Mohammed ALBashtawy
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Shaher H. Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Khitam Ibrahem Mohammad
- Department of Midwifery, Faculty of Nursing, University of Science &Technology, Irbid, Jordan
| | - Abdullah Alkhawaldeh
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Manar Alazzam
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | | | - Mohammad Suliman
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Bayan ALBashtawy
- Jordan Ministry of Health, Bachelor of Medicine and Surgery, Irbid, Jordan
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49
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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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50
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Heger I, Deckers K, de Vugt M, Verhey F, Oenema A, van Boxtel M, Köhler S. Using mHealth for Primary Prevention of Dementia: A Proof-of-Concept Study on Usage Patterns, Appreciation, and Beliefs and Attitudes Regarding Prevention. J Alzheimers Dis 2023; 94:935-948. [PMID: 37355903 PMCID: PMC10473134 DOI: 10.3233/jad-230225] [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: 05/16/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Health- and lifestyle factors account for a substantial part of all dementia cases, which opens the opportunity for primary prevention. However, the required behavioral change is complex and involves targeting multiple risk factors. mHealth interventions can potentially contribute to improving motivation in a low-cost and scalable way. OBJECTIVE To explore usage patterns, appreciation, and beliefs and attitudes regarding dementia risk reduction during the use of the MyBraincoach mobile app. METHODS Participants were community-dwelling middle-aged adults from the Netherlands and used either the standard (education) or extended (education+motivational triggers) app version for three months. Two panel studies were combined in this paper. Chi-square tests, t-tests and linear mixed models were used, adjusted for age, sex, and education. RESULTS Of all participants (n = 299, 50.2% male), 167 (55.9%) had installed the app. The most reported reason for non-use was technical problems (47%). Those who used the app were at baseline already more positive about dementia risk reduction than those who did not use the app. Of all users who completed the evaluation (n = 102), 78.4% (n = 80) stated that the app provided a positive approach towards brain health and 80.4% (n = 82) felt better informed. Younger (<60y) and lower educated participants evaluated the app most positively. CONCLUSION Usage of the app was low, but users showed more positive beliefs and attitudes regarding dementia risk reduction. Most users evaluated the app positively and stated to have gained knowledge on the topic. Improving the use of the app must keep high priority in future studies.
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Affiliation(s)
- Irene Heger
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anke Oenema
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute Maastricht, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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