Factors Associated With Dementia Knowledge and Dementia Worry in the South Korean Elderly Population

Establishing a unified global framework for studying dementia knowledge: insights from a narrative review

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.

Differences in dementia prevention knowledge by educational attainment: an analysis of a household survey from Great Britain

Background

Higher levels of education are associated with slower cognitive decline and a lower risk of dementia, with some evidence of a causal relationship. However, the mechanisms explaining these associations are not well established.

Methods

We collected data on dementia knowledge using a cross-sectional household survey representative of the population of Great Britain. Dementia knowledge was assessed using a self-reported measure and a question measuring the knowledge of key risk factors. We examined whether dementia knowledge varied by levels of education (as measured by the level of the highest qualification) by fitting logistic regressions adjusted for confounding factors.

Findings

Out of the 5036 respondents aged 25 or over (46.6% male; average age 63.8), 9.3% reported knowing a great deal about dementia, and 32.2% quite a lot. We found a strong educational gradient in dementia prevention knowledge. For people with a degree qualification compared with people with no formal qualification, the ORs of reporting having quite a lot or a great deal of knowledge about dementia were 2.54 (95% CIs 1.81 to 3.56). The ORs were 3.58 (2.61 to 4.91) for mentioning all risk factors. The difference in awareness by educational level was largest for some risk factors such as lack of physical and mental activity, alcohol consumption and poor mental health.

Interpretation

The protective effect of higher levels of education against the risk of dementia may partly be driven by differences in dementia prevention knowledge. Health education efforts on dementia prevention should target people with lower levels of education to reduce inequalities in dementia prevalence.

Positive Neuropsychological Factors Associated With Greater Engagement in Brain Health Behaviors in Older Adults

Background: Research has examined the influence of positive psychological factors including purpose in life (PIL), need for cognition (NFC), and psychological flexibility on behaviors that support brain health (i.e., preserved cognitive functioning and brain structures). However, more research is needed to examine their predictive validity in relation to other important factors in this context including emotional distress and dementia worry. Objective: The current study included 348 older adults who completed self-report measures of PIL, NFC, psychological flexibility, emotional distress, dementia worry, and brain health behavior engagement via Qualtrics. Results: Greater PIL was associated with more engagement in all brain health behaviors while NFC was only associated with more cognitive activity, heart health monitoring, and stress management. Psychological flexibility mediated the association between PIL and engagement. Conclusion: Our findings add evidence to the incremental validity of positive neuropsychological factors on engagement in brain health behaviors. Implications for neuropsychological interventions are discussed.

'If you've lost your personality, there's no point in changing the valve'-a qualitative study of older adults' attitudes towards treatment of aortic stenosis with comorbid dementia

OBJECTIVES

Due to prognostic uncertainty and limited decision-making capacity, the choice to perform transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS) and comorbid dementia is challenging. This study explores older adults' perspectives on complex decision-making preceding TAVI in the hypothetical setting of comorbid dementia.

DESIGN

Qualitative study entailing semistructured interviews. Analysis was by systematic text condensation. The interview guide addressed their attitudes regarding treatment dilemmas before TAVI in patients living with dementia.

SETTING

Patients were recruited from the TAVI outpatient clinic at a university hospital performing TAVI.

PARTICIPANTS

A purposive sample of 10 older adults (5 women) with AS and without dementia (range 77-94 years), where 8/10 had undergone TAVI were included.

RESULTS

Three main challenges were identified: (1) Risk assessment. Participants found it hard to compare the burden of aortic stenosis vs dementia. They acknowledged the dilemma of implanting a new heart valve to achieve symptom relief while risking severe dementia in the future due to prolonged life span. (2) Autonomous capacity. A profound uncertainty was described regarding who should participate in decision-making if the person was incapacitated due to dementia. (3) Customised information. Participants advocated for thorough information describing facts and uncertainty, aiming to protect and support the person living with dementia.

CONCLUSION

Older adults with severe aortic stenosis find it hard relating to dilemmas arising from providing TAVI in patients living with dementia. There is a need for tailor-made information to support autonomy and decision-making under uncertainty.

Perceived Threat of Alzheimer's Disease and Related Dementias Among Chinese Family Caregivers of Older Adults with Cognitive Impairment

Perceived threat of Alzheimer's disease and related dementias (ADRD) has been found a widespread phenomenon in developed countries, but has not yet been fully explored in developing countries. Analyzing data from 300 family caregivers of older adults with cognitive impairment in China, this study found caregiver burden was positively associated with the perceived threat of ADRD, and this association was buffered by higher family income and longer caregiving time. To alleviate undue ADRD concerns, it suggests expanding respite care and community elder care beds, and initiating education programs on reducing unnecessary worries about developing ADRD.

Awareness and Perception Toward Alzheimer's Disease Among Residents Living in the Jazan Province, Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Alzheimer's disease (AD) is a growing public health concern, yet misconceptions about the condition are common. This study assessed awareness and social perceptions of AD in Jazan.

METHODS

A cross-sectional survey of 925 adults was conducted. Knowledge was assessed using a 30-item Alzheimer's Disease Knowledge Scale (ADKS). Social perceptions were evaluated using a 10-item questionnaire.

RESULTS

Many had misconceptions about AD epidemiology, causes, management, and care. The mean ADKS score was 8.89 ± 5.17 out of 30. Knowledge was poorest for symptoms, risk factors, treatment, caregiving, and life impact. Knowledge was highest in those aged >45 years (p = 0.018), in those with income > 15K SR (p = 0.004), in retired individuals (p = 0.023), and in those who learned about AD from books (p = 0.001), healthcare professionals (p = 0.001), or had an affected relative (p = 0.001). However, knowledge was low across all domains, averaging only 29% correct answers. Most respondents held positive social perceptions, yet sizable minorities saw isolation, legal intervention, and institutionalization as appropriate. Additionally, a portion of respondents associated stigma with individuals affected by AD and expressed a sense of burden associated with the condition.

CONCLUSIONS

There are substantial knowledge gaps and some stigmatizing attitudes about AD in Jazan. Awareness regarding the causes, diagnosis, and management of AD was low. Misconceptions exist that AD only affects older people. Improved public education, especially for higher-risk groups, is needed to address misconceptions and promote social inclusion for those with dementia. Healthcare professionals can play a crucial role.

Changes in the prevalence of dementia in Australia and its association with geographic remoteness

BACKGROUND

The exact prevalence of dementia in Australia is ambiguous. Australia is a vast continent with a small population, and 80% of the population live in five cities. This study explores recent changes in the prevalence of dementia. It also investigates geographic remoteness as a potential risk factor for developing dementia.

METHODS

Survey of Disability, Ageing and Carers (SDAC), a nationally representative database, was used to conduct this study. A total of 74,862 and 65,487 individuals from 2015 and 2018, respectively, were considered for this study. A multivariable logistic regression model was used to evaluate the association between dementia and geographic remoteness for older adults aged 65 years and over.

RESULTS

The results reveal that from 2015 to 2018, the prevalence of dementia among adults aged 65 years and older was higher in 2018 (5,229 per 100,000) than in 2015 (5,099 per 100,000). Significant geographical differences in the prevalence of dementia are observed among Australian adults, and this trend appears to be increasing. Furthermore, the unadjusted model revealed that, in 2015, older adults living in major cities had 1.29 (AOR: 1.29, 95% CI: 1.17-1.41) times higher odds of having dementia compared with their counterparts from outer regional and remote areas. In 2018, the adjusted model found that older adults living in major cities had 1.12 (AOR: 1.12, 95% CI: 1.01-1.25) times elevated odds of having dementia than their peers living in outer regional and remote areas.

CONCLUSION

There is a rising prevalence of dementia in Australia. Further investigation is required to identify the causes of this increase. Increased public health initiatives should concentrate on behavioural characteristics and contextual environmental factors to ameliorate this trend.

Perceptions and worries about monkeypox, and attitudes towards monkeypox vaccination among medical workers in China: A cross-sectional survey

BACKGROUND

The World Health Organization (WHO) declared monkeypox a "public health emergency of international concern" on 23 June 2022. However, there is a lack of data on monkeypox perceptions among medical workers. The purposes of this study were to evaluate perceptions, worries about monkeypox, attitudes towards monkeypox vaccination and their correlates among medical workers in China.

METHODS

Data were collected from medical practitioners using an online survey questionnaire between September 1 and September 30, 2022 in China. All the subjects completed an online questionnaire including general characteristics, perceptions/knowledge/worries about monkeypox, and attitudes towards monkeypox vaccination. Logistic regression was employed to examine the correlates of perceptions, worries about monkeypox, and attitudes toward monkeypox vaccination.

RESULTS

In total, this study sample included 639 medical workers. The mean age was 37.9 ± 9.4 years old. Approximately 71.8% of individuals reported perceptions of monkeypox, 56.7% worried about monkeypox, and 64.9% supported the promotion of monkeypox vaccination. Medical workers who were older than 50 years (aOR 3.73, 95%CI 1.01-13.85), worked in the Infectious Diseases/Dermatology/Venereal Diseases departments (3.09, 1.61-5.91), and provided correct answer to monkeypox transmission route (10.19, 5.42-19.17) were more likely to know about monkeypox/monkeypox virus before investigation. 30.7% reported that they were more worried about monkeypox than the coronavirus (COVID-19). Participants reported that the key population most in need of monkeypox vaccination were health practitioners (78.2%) and people with immunodeficiency (74.3%), followed by children (65.4%) and older adults (63.2%).

CONCLUSION

Awareness of monkeypox was high and attitude towards the promotion of monkeypox vaccination was positive among medical staff in China. Further targeted dissemination of monkeypox common knowledge among health care providers might improve their precaution measures and improve the promotion of monkeypox vaccination among key populations.

Public awareness, specific knowledge, and worry about mpox (monkeypox): A preliminary community-based study in Shenzhen, China

Background

The mpox (monkeypox) outbreak has been declared to be a public health emergency of international concern by the Director-General of World Health Organization in July 2022. However, evidence regarding the awareness, knowledge, and worry about mpox in the general population remains scant.

Methods

A community-based survey targeting community residents was preliminarily conducted in Shenzhen, China in August 2022 by using a convenience sampling method. Information on mpox-related awareness, knowledge, and worry was collected from each participant. Binary logistic regression analyses with the stepwise procedure were applied to explore the factors associated with awareness, knowledge, and worry about mpox.

Results

A total of 1028 community residents were included in the analysis (mean age: 34.70 years). Among these participants, 77.9% had ever heard of mpox, and 65.3% were aware of the global outbreak of mpox. However, only about half of them had a high level of knowledge regarding mpox (56.5%) and related symptoms (49.7%). More than one-third of them (37.1%) expressed a high level of worry about mpox. Having high knowledge levels of mpox and related symptoms were positively associated with a high level of worry (OR: 1.79, 95%CI: 1.22~2.63 for a single high knowledge level; OR: 1.98, 95%CI: 1.47~2.66 for both high knowledge levels).

Conclusions

This study identified the gaps in public awareness and specific knowledge of mpox in Chinese people, providing scientific evidence for the prevention and control network of mpox at the community level. Targeted health education programs are of urgent need, which should be implemented along with psychological interventions to release public worry if necessary.

How Are Sociodemographic, Health, Psychological, and Cognitive Factors Associated with Dementia Worry? An Online Survey Study among Israeli and Australian Laypeople

BACKGROUND

Dementia worry is a widespread phenomenon and the most common emotional reaction elicited by the threat of developing dementia in the future. The cultural factors of dementia worry have not been examined widely, although dementia can be perceived differently between cultures and lead to varying levels of dementia worry. The purpose of this study was to examine the level of dementia worry and factors associated with it cross-nationally in Israel and Australia.

METHODS

A cross-sectional, online survey was conducted with two age-matched adult samples (447 participants in Israel and 290 in Australia). The primary outcome measure was the 12-item Dementia Worry Scale.

RESULTS

Israeli participants (mean age = 42.5 years; 50.1% female) reported statistically significantly (p < 0.05) higher levels of concern about developing dementia in comparison to Australian participants (mean age = 43.7 years; 49.8% female). Increased ageism and increased perceptions about the likelihood of developing dementia were the most important factors associated with increased worry.

CONCLUSIONS

Our findings suggest that country may not be the best criterion to assess cultural differences and should be accompanied by the participants' assessment of their cultural tendencies. Our study also stresses the importance of conceptualizing and assessing affective and cognitive aspects of dementia worry, as people from different cultures might perceive dementia worry cognitively differently but affectively similar and vice-versa.