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Güney S, Çiçek Doğan Ö, Bakır A, Öztürk A, Oldaç T. Dementia Risk Awareness, Health Behaviors and Motivation for Dementia Prevention in Middle-Aged and Older Adults in Türkiye. J Appl Gerontol 2024:7334648241251771. [PMID: 38741256 DOI: 10.1177/07334648241251771] [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: 05/16/2024] Open
Abstract
This study aimed to investigate factors influencing motivation for dementia preventive behaviors in a population aged 40 and over. We conducted a descriptive cross-sectional study between December 2022 and May 2023, involving 483 participants in an online survey. We collected data on dementia risk awareness, healthy lifestyle choices, and motivation for dementia risk reduction. The majority of respondents, comprising 41.6%, demonstrated a moderate level of risk awareness, with 50.5% believing that prevention is beyond anyone's control. Motivations for lifestyle change were significantly higher in women (p < .001) and `participants with university degree education (p < .05). Regression analysis identified gender (female), education level (higher education), and dementia risk awareness, emerged as significant predictors of motivation to change lifestyle (beta: .138, beta: .136, beta: .114, p < .001, respectively). This study underscores the importance of risk awareness in motivating dementia prevention, suggesting avenues for future research to explore specific determinants of motivation to reduce dementia risks.
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Affiliation(s)
- Seda Güney
- Faculty of Nursing, Koç University, Istanbul, Turkey
| | | | - Aylin Bakır
- Faculty of Nursing, Koç University, Istanbul, Turkey
| | - Ayça Öztürk
- Faculty of Nursing, Koç University, Istanbul, Turkey
| | - Tuğçe Oldaç
- Faculty of Nursing, Koç University, Istanbul, Turkey
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Kim J, Kim MY, Kim JA, Lee Y. Factors affecting preventive behaviors of Alzheimer's disease in family members of patients with Alzheimer's disease. Medicine (Baltimore) 2022; 101:e31136. [PMID: 36281127 PMCID: PMC9592491 DOI: 10.1097/md.0000000000031136] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As genetic factors increase the risk of Alzheimer's disease (AD), the families of dementia patients are at risk of AD. We aimed to evaluate the factors affecting preventive behaviors of AD in family members of AD patients. Using constructed questionnaire based on the Health Belief Model (HBM) theoretical framework, this cross-sectional study investigated factors influencing preventive behaviors of AD such the intention to take AD-preventive medicines, prior experience of taking cognitive function supplements, and AD-preventive lifestyle. 147 family members of AD patients were recruited through the Korea Alzheimer's Caregiver Association. Out of 147 participants, 94.6% had intention to take AD-preventive medicines and 46.3% had experience of taking cognitive function supplements. The intention to take AD-preventive medicines were significantly influenced by self-efficacy (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.03, 1.87) and dementia knowledge (OR 3.42, 95% CI 1.13, 10.39), whereas prior experience of cognitive function supplements was significantly associated with cue to action (OR 1.22, 95% CI 1.07, 1.40). AD-preventive lifestyle was significantly influenced by socio-demographics such as age, sex, and marital status, and the HBM factors such as perceived susceptibility, self-efficacy, and cue to action. Self-efficacy, cue to action, dementia knowledge, and perceived susceptibility were significantly associated with preventive behaviors of AD. Also, family members of dementia patients, who are at risk of dementia due to genetic factors, lifestyles, and environment factors, had high level of AD-preventive lifestyle and strong intention to take AD-preventive medicines. Further research could be suggested to understand AD-preventive behavior and intention to take AD-preventive medicines in general population.
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Affiliation(s)
- JiEun Kim
- Medical, Eisai Korea Inc, Gangnam-gu, Seoul, Republic of Korea
- *Correspondence: JiEun Kim, Department of Medical, Eisai Korea Inc, 6 Bongeunsa-ro 86-gil, Gangnam-gu, Seoul, Republic of Korea (e-mail: )
| | - Min Young Kim
- Medical, Eisai Korea Inc, Gangnam-gu, Seoul, Republic of Korea
| | - Jung-Ae Kim
- Real World Solutions, IQVIA Korea, Jung-gu, Seoul, Republic of Korea
| | - Youngeun Lee
- Real World Solutions, IQVIA Korea, Jung-gu, Seoul, Republic of Korea
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Jacobson M, Joe E, Zissimopoulos J. Barriers to seeking care for memory problems: A vignette study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12238. [PMID: 35310532 PMCID: PMC8919244 DOI: 10.1002/trc2.12238] [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: 09/20/2021] [Revised: 12/01/2021] [Accepted: 12/15/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This study compares how older adults judge the need for follow-up care for memory-related problems when they are responding about themselves versus someone of the same age. METHODS Adults ages 65 and over in the Understanding America Study, a nationally representative internet panel, were invited to participate in a short survey with three vignettes describing memory-related problems associated with normal aging, mild cognitive impairment, and mild dementia. Respondents were randomly assigned to vignettes about themselves or about an individual of the same age and asked whether the problems warranted follow-up discussion with a health-care provider. Unadjusted and covariate-adjusted differences in the percent of affirmative responses to follow-up discussion and an index, ranging from 0 to 3, that summed affirmative responses, were compared across respondents randomly assigned to self- versus other-framed vignettes. RESULTS One thousand six hundred twenty-eight panel members (81.6%) completed the survey (mean age, 72.3 [range, 65-102], 801 female [49.2%] and 827 male [50.8%]) with 796 (48.9%) randomly assigned to vignettes about themselves and 832 (51.1%) to vignettes about individuals of the same age. Percent affirming need for follow-up ranged from 66.9% to 90.5% and was systematically lower for those randomized to vignettes about themselves. The differences ranged from -10.8 percentage points (95% confidence interval [CI], -13.6 to -7.9 percentage points) for the most severe to -13.9 percentage points (95% CI, -18.1 to -9.7 percentage points) for the mildest memory-related problem vignettes. The summary index was -0.444 points (95% CI, 0.563 to -0.326) or 0.491 of a standard deviation (95% CI, 0.622σ to -0.362σ) lower for scenarios about participants themselves relative to others. DISCUSSION Seniors were more likely to recognize and recommend follow-up for memory-related problems affecting someone else than the same problems affecting themselves, suggesting symptom education alone may not improve rates of cognitive assessment for detection of impairment and dementia.
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Affiliation(s)
- Mireille Jacobson
- University of Southern CaliforniaDavis School of GerontologyLos AngelesCaliforniaUSA
- University of Southern CaliforniaSchaeffer Center for Health Policy & EconomicsLos AngelesCaliforniaUSA
- National Bureau of Economic ResearchCambridgeMassachusettsUSA
| | - Elizabeth Joe
- Department of Neurology, University of Southern CaliforniaKeck School of MedicineLos AngelesCaliforniaUSA
| | - Julie Zissimopoulos
- University of Southern CaliforniaDavis School of GerontologyLos AngelesCaliforniaUSA
- University of Southern CaliforniaSchaeffer Center for Health Policy & EconomicsLos AngelesCaliforniaUSA
- Department of Health Care Management and Policy, University of Southern CaliforniaPrice School of Public PolicyLos AngelesCaliforniaUSA
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Choi WH, Seo YM. Determinants of Intention Toward Dementia-Preventive Behaviors Among Middle-Aged Korean Adults. Int J Aging Hum Dev 2021; 95:57-71. [PMID: 34134528 DOI: 10.1177/00914150211024180] [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: 11/15/2022]
Abstract
This study aims to determine the influence of the constructs of the health belief model and fear of dementia on the behavioral intention to prevent middle-aged Korean adults' dementia. Applying a descriptive design, 163 middle-aged adults were recruited. Structured questionnaires were used to collect data regarding fear of dementia, behavioral intention to prevent dementia, the expanded health belief model's variables (i.e., perceived susceptibility, perceived severity, perceived benefit, perceived barrier, cues to action, general health motivation, and self-efficacy), and other general characteristics between August and September 2019. The determinants of the behavioral intention for dementia prevention were identified through hierarchical regression analysis. The significant factors influencing the behavioral intention for dementia prevention were general health motivation and self-efficacy, accounting for 34.2% of the variance. The results revealed key factors that should be considered in future interventions to enhance adherence concerning dementia-preventive behaviors.
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Affiliation(s)
- Won-Hee Choi
- 34987 Department of Nursing, Kyungsung University, Busan, Korea
| | - Yeong-Mi Seo
- 250455 Department of Nursing, Gyeongnam National University of Science and Technology, Jinju, Korea
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Park J, Tolea M, Besser L, Galvin J. Intention to Be Screened for Alzheimer's Disease in Nondemented Older Adults: Integrated Behavioral Model and Self-Efficacy as Mediation Effect. JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT 2020; 30:778-796. [PMID: 33364731 PMCID: PMC7751942 DOI: 10.1080/10911359.2020.1752349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The study explored factors associated with intention to be screened for Alzheimer's disease (AD). The study also examined whether self-efficacy mediates the relationship between knowledge about screening and the intention to be screened for AD. A population-based, random-digit dialing survey was performed and 1,043 responses were collected from a sample of nondemented persons (50 years or older) living in urban, suburban, and rural areas in a Midwestern state. The findings showed that participants who were younger and who had higher levels of (a) perceived benefits and barriers, (b) social support, and (c) self-efficacy reported higher levels of intention to be screened for AD. Older adults with positive life orientation reported greater intention to be screened for AD, whereas depressed participants were more likely to report a plan to be screened for AD. Self-efficacy mediated the relationship between knowledge about screening and intention to be screened. Older adults were more likely to report intention to be screened when they had positive attitudes about the screen and believed that they could receive the screen. The intention to be screened for AD could serve public awareness by defining effective ways to assist older adults to seek a cognitive screen.
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Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University
| | - Magdalena Tolea
- University of Miami, Miller School of Medicine, Department of Neurology
| | - Lilah Besser
- School of Urban & Regional Planning, Florida Atlantic University
| | - James Galvin
- University of Miami, Miller School of Medicine, Department of Neurology
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Akyol MA, Zehirlioğlu L, Erünal M, Mert H, Hatipoğlu NŞ, Küçükgüçlü Ö. Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction. Am J Alzheimers Dis Other Demen 2020; 35:1533317519898996. [PMID: 32048860 PMCID: PMC10624097 DOI: 10.1177/1533317519898996] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Global population is getting older and the prevalence of dementia continuously increases. Understanding the related health beliefs is bound to enable lifestyle-based interventions that maximize public engagement in dementia risk reduction behaviors. The aim of this study was to determine health beliefs on dementia prevention behaviors and lifestyle changes and to determine the factors influencing these beliefs among middle-aged and older people in Turkey. MATERIALS AND METHODS This descriptive and cross-sectional study was conducted with 284 individuals aged 40 years and older, using nonprobability convenience sampling. Data were collected using a demographic characteristic form and the Turkish version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia scale. The study utilized the value, mean, percentage frequency distribution, correlation, independent t test, and the one-way analysis of variance test. RESULTS The mean age of the participants included in the study was 56.99 ± 12.05, 68.7% of individuals were males. The mean education years of the participants were 11.22 ± 4.55. The majority (72.2%) of participants expressed subjective memory complaints. Presence of family history of dementia was 28.2%. Age, gender, education years, subjective memory complaints, presence family history of dementia, prior experience as a caregiver of dementia, and willingness to know their own risk were determined as essential factors that influence several health belief factors related to dementia risk reduction. CONCLUSION Our findings indicate that males, older adults, and lower-educated and income are priority groups that should be guided for lifestyle and behavioral changes regarding dementia risk reduction.
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Affiliation(s)
- Merve Aliye Akyol
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
- Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Lemye Zehirlioğlu
- Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Merve Erünal
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
- Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Hatice Mert
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
| | - Nur Şehnaz Hatipoğlu
- Ministry of Health, Konak 24th MF. Özsaruhan Primary Care Clinic, Izmir, Turkey
- Elderly Health Doctorate Programme, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
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Lincoln KD, Chow TW, Gaines BF. BrainWorks: A Comparative Effectiveness Trial to Examine Alzheimer's Disease Education for Community-Dwelling African Americans. Am J Geriatr Psychiatry 2019; 27:53-61. [PMID: 30409550 DOI: 10.1016/j.jagp.2018.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/08/2018] [Accepted: 09/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To test a culturally tailored intervention to improve Alzheimer's disease (AD) literacy among African Americans. DESIGN A 3-arm randomized comparative effectiveness trial. SETTING Community sites in Los Angeles, CA. PARTICIPANTS 193 African American community-dwelling adults, ages 45 to 95 years old. INTERVENTION All groups attended BrainWorks Live, a culturally tailored, 60-minute talk show and received standard printed educational materials on AD. From there: a) the BrainWorks Live group received no further contact until the post-test; b) one intervention group received a 1-month, culturally tailored, unidirectional, daily text-message program; and c) a second intervention group received daily text messages based on the printed educational materials that the general public would receive. AD literacy was measured at baseline and one month post intervention. MEASUREMENTS Alzheimer's disease literacy and demographic and health covariates. RESULTS At one month, participants who received culturally tailored text messages had the highest increase in AD literacy levels, followed by those in the BrainWorks Live arm. Participants who received general text messages had a lower overall increase in AD literacy levels compared to the other arms, but had higher mean AD literacy levels than the BrainWorks Live arm. There was a significantly greater increase in AD literacy levels among participants who received culturally tailored text messages compared with those who attended BrainWorks Live only. There were no other statistically significant differences between arms. CONCLUSIONS AD literacy among African Americans can be improved after only one month through culturally competent, economically feasible educational formats.
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Affiliation(s)
- Karen D Lincoln
- University of Southern California, Suzanne Dworak-Peck School of Social Work.
| | - Tiffany W Chow
- University of Southern California, Alzheimer's Therapeutic Research Institute
| | - Bryan F Gaines
- University of Southern California, Suzanne Dworak-Peck School of Social Work
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Yuki-Nozaki S, Noguchi-Shinohara M, Domoto C, Ikeda Y, Samuraki M, Iwasa K, Yokogawa M, Asai K, Komai K, Nakamura H, Yamada M. Differences in Dementia Beliefs between Non-Demented Public Screeners and In-Home Screeners and Their Potential Impact on Future Dementia Screening Intention: The Nakajima Study. J Alzheimers Dis 2018; 62:1651-1661. [PMID: 29614687 DOI: 10.3233/jad-171177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In many cohort studies of dementia, while differences in sociodemographic characters between responders and non-responders of dementia screening have been reported, differences in dementia beliefs have been relatively less known. The aims of this study were to clarify dementia beliefs and to explore potential impacts on an intention to attend a future dementia screening in public screeners and in-home screeners, respectively. We performed a cross-sectional population-based study using a question about an intention to attend a future dementia screening and a questionnaire on dementia beliefs. Subjects were all residents aged 65 years or older in the north area of Nakajima, Japan (n = 385). All subjects were asked to attend a public dementia screening first. An in-home dementia screening was subsequently conducted in subjects with non-responders to a public screening. The questionnaire consisted of four dementia beliefs: "perceived susceptibility," "perceived severity," "perceived barriers," and "perceived benefits." Public screeners significantly expressed an intention to attend a future dementia screening more than in-home screeners (p = 0.002). In in-home screeners, low "perceived severity" were significantly associated with an intention to attend a future dementia screening [adjusted OR (95% CI) = 0.51 (0.32-0.80)]. In both public and in-home screeners, high "perceived benefits" were significantly associated with an intention to attend a future dementia screening [adjusted OR (95% CI) = 2.13 (1.46-3.10); adjusted OR (95% CI) = 2.56 (1.22-5.35), respectively]. It is necessary to reduce "perceived severity" among in-home screeners to increase dementia screening participants.
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Affiliation(s)
- Sohshi Yuki-Nozaki
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Moeko Noguchi-Shinohara
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Chiaki Domoto
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Yoshihisa Ikeda
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Miharu Samuraki
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Kazuo Iwasa
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Masami Yokogawa
- Department of Physical Therapy, School of Health Sciences, College of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kimiko Asai
- Bishoen Geriatric Health Services Facility, Suzu, Ishikawa, Japan
| | - Kiyonobu Komai
- Department of Neurology, Iou Hospital, National Hospital Organization, Kanazawa, Ishikawa, Japan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Masahito Yamada
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
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Shinan-Altman S, Werner P. Is there an association between help-seeking for early detection of Alzheimer's disease and illness representations of this disease among the lay public? Int J Geriatr Psychiatry 2017; 32:e100-e106. [PMID: 28111803 DOI: 10.1002/gps.4661] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 12/11/2016] [Accepted: 12/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Help-seeking (HS) for early detection of Alzheimer's disease (AD) is clearly essential because therapeutic interventions are recognized as being most efficient in the early stages of the disease. Using the Self-Regulation Model as its conceptual framework, the present study examined the relationship between HS for early detection of AD and lay persons' beliefs and emotional reactions towards AD. METHODS A convenience sample of 236 community-dwelling adults, aged 50 and above, completed HS measures related to early detection of AD, HS sources, cognitive and emotional representations, perceived threat, familiarity with AD, and socio-demographic questionnaires. RESULTS Participants expressed low HS levels for early detection of AD. However, participants expressed higher levels of HS willingness if checking for AD would be included in the routine medical examinations conducted by their GPs. Multiple regression analyses showed that AD consequences and perceived threat were the main predictors of HS for early detection of AD, explaining 9.2% of the variance. CONCLUSIONS Our findings stress the need to increase the lay public's knowledge about available treatment options and their efficacy, even in the advances stages of the disease when the consequences of the disease are much more severe. AD awareness programs should also pay attention to the potential fear which may exist in the case of HS for early detection of AD. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat-Gan, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Mount Carmel, Haifa, Israel
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Werner P, Goldstein D, Karpas DS, Chan L, Lai C. Help-seeking for dementia: a systematic review of the literature. Alzheimer Dis Assoc Disord 2015; 28:299-310. [PMID: 25321607 DOI: 10.1097/wad.0000000000000065] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Help-seeking (HS) for dementia presents a great challenge, especially because a timely and appropriate HS process might be associated with better outcomes for the person with dementia, their caregivers, and society. A clear understanding of the HS concept and its measurement in the area of dementia might improve the effectiveness of the process. AIMS The aims of our systematic review were: (1) to systematically obtain and evaluate the relevant literature on HS and dementia; and (2) to summarize current research findings and draw conclusions for future research and clinical care in this area. METHOD A systematic review of the literature on HS and dementia was conducted up till June 2013. RESULTS From the 478 retrieved articles, 48 were included in the review. Conceptually, the studies examined professional and nonprofessional sources of help; showed preference for seeking help from close relatives followed by primary health caregivers; and identified inadequate knowledge and stigmatic beliefs as the main barriers to HS. The majority of the studies did not rely on a theoretical framework. CONCLUSIONS Although the body of literature in the area of HS and dementia is growing, several conceptual and methodological limitations still have to be resolved to advance knowledge in the area.
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Affiliation(s)
- Perla Werner
- *Department of Community Mental Health †Center for Research and Study of Aging, University of Haifa, Haifa, Israel ‡Ho Cheung Shuk Yuen Charitable Foundation, Hong Kong §Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Breslow RM. Patient attitudes regarding pharmacist-administered memory screening in community pharmacies. J Am Pharm Assoc (2003) 2014; 53:648-51. [PMID: 24185433 DOI: 10.1331/japha.2013.12227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To describe patient attitudes toward pharmacist-administered memory screening in community pharmacies and assess patient satisfaction with screening in this venue. METHODS One pharmacist in each of two pharmacies performed a background assessment and administered the Mini-Mental State Examination, the category (animal) fluency test, and the clock-drawing test to participants 60 to 75 years of age with no previous diagnosis of cognitive impairment and who were not taking a prescribed medication for dementia. Participants then completed a 28-item Likert-type scale evaluation. Responses to survey items of "agree" and "strongly agree" were aggregated. RESULTS 26 participants were recruited with a mean (±SD) age of 66.7 ± 5.5 years. Agree and strongly agree response rates of 75% or greater were considered indicative of strongly positive attitudes or beliefs and likely to influence participants' decisions to be screened in community pharmacies. The majority of participants responded favorably to several aspects of offering memory screening in pharmacies, including the accuracy of testing by a trained pharmacist (84%), willingness to be screened by a trained pharmacist (80%), willingness to undergo annual screening (92%), and convenience of the pharmacy as a location for memory screening (100%). A slightly lower percent of participants (72%) agreed or strongly agreed that they would be willing to have their memory tested in any pharmacy offering the service. Less than one-half of participants (45.5%) indicated that they would be willing to pay out of pocket for the screening. CONCLUSION Responses to the evaluation and statistically significant correlations among evaluation items suggested that memory screening by pharmacists in community pharmacies was a feasible, acceptable, and convenient venue for routine screening.
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Kim S, Sargent-Cox K, Cherbuin N, Anstey KJ. Development of the motivation to change lifestyle and health behaviours for dementia risk reduction scale. Dement Geriatr Cogn Dis Extra 2014; 4:172-83. [PMID: 25028583 PMCID: PMC4086035 DOI: 10.1159/000362228] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background and Aims It is not yet understood how attitudes concerning dementia risk may affect motivation to change health behaviours and lifestyle. This study was designed to develop a reliable and valid theory-based measure to understand beliefs underpinning the lifestyle and health behavioural changes needed for dementia risk reduction. Methods 617 participants aged ≥50 years completed a theory-based questionnaire, namely, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale. The MCLHB-DRR consists of 53 items, reflecting seven subscales of the Health Belief Model. Results Confirmatory factor analysis was performed and revealed that a seven-factor solution with 27 items fitted the data (comparative fit index = 0.920, root-mean-square error of approximation = 0.047) better than the original 53 items. Internal reliability (α = 0.608-0.864) and test-retest reliability (α = 0.552-0.776) were moderate to high. Measurement of invariance across gender and age was also demonstrated. Conclusions These results propose that the MCLHB-DRR is a useful tool in assessing the beliefs and attitudes of males and females aged ≥50 years towards dementia risk reduction. This measure can be used in the development and evaluation of interventions aimed at dementia prevention.
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Affiliation(s)
- Sarang Kim
- Centre for Research on Ageing, Health and Well-Being, Australian National University, Canberra, A.C.T., Australia
| | - Kerry Sargent-Cox
- Centre for Research on Ageing, Health and Well-Being, Australian National University, Canberra, A.C.T., Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Well-Being, Australian National University, Canberra, A.C.T., Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Well-Being, Australian National University, Canberra, A.C.T., Australia
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Werner P, Heinik J, Giveon S, Segel-Karpas D, Kitai E. Help-seeking preferences in the area of mild cognitive impairment: comparing family physicians and the lay public. Clin Interv Aging 2014; 9:613-9. [PMID: 24748779 PMCID: PMC3986294 DOI: 10.2147/cia.s60248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Mild cognitive impairment (MCI) or mild neurocognitive disorder is a well-established clinical entity included in current diagnostic guidelines for Alzheimer’s disease and in major psychiatric classifications. In all, a loosely defined concern obtained from conceptually different sources (the individual, a knowledgeable informant, or a clinician) regarding a decline in cognition and change in functioning constitutes a sine qua non for initiating diagnostics and providing therapy and support. This concern in practice may translate into complex proactive help-seeking behavior. A better understanding of help-seeking preferences is required in order to promote early detection and management. Objectives To compare help-seeking preferences of family physicians and the lay public in the area of MCI. Methods A structured questionnaire was used to collect data from 197 family physicians (self-administered) and 517 persons aged 45 and over from the lay public (face to face). Information regarding familiarity with MCI and help-seeking preferences was assessed. Results The vast majority in both samples reported that family physician, spouse, and children are the most highly recommended sources of help-seeking. In regard to professional sources of help-seeking, a higher percentage of the physicians than the lay public sample consistently recommended seeking help from nurses and social workers and psychiatrists, but a higher percentage of the lay public recommended turning to a neurologist for help. Discussion There were both similarities and differences between family physicians and the lay public in their preferences regarding help-seeking for a person with MCI. Most prominent is the physicians’ greater tendency to recommend professional sources of help-seeking. Conclusion Understanding of help-seeking preferences of both physicians and lay persons might help overcome barriers for establishing diagnosis, receiving care, and improving communication between doctors and patients.
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Affiliation(s)
- Perla Werner
- Center for the Research and Study of Aging, University of Haifa, Haifa, Israel
| | - Jeremia Heinik
- Margoletz Psychogeriatric Center, Ichilov Hospital, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Dikla Segel-Karpas
- Center for the Research and Study of Aging, University of Haifa, Haifa, Israel
| | - Eliezer Kitai
- Department of Family Medicine, Leumit Health Services, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lin F, Gleason CE, Heidrich SM. Illness representations in older adults with mild cognitive impairment. Res Gerontol Nurs 2012; 5:195-206. [PMID: 22716654 DOI: 10.3928/19404921-20120605-04] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 08/25/2011] [Indexed: 11/20/2022]
Abstract
Little is known about patients' understanding of a diagnosis of mild cognitive impairment (MCI). The purpose of this cross-sectional descriptive study was to describe beliefs about MCI in people diagnosed with the condition and examine correlates (demographic and health) of those beliefs. Thirty individuals diagnosed with MCI completed the Illness Perception Questionnaire-MCI (IPQ-MCI), measuring eight domains of beliefs about MCI, and one scale of emotional distress. Five of them also participated in a 15-minute cognitive interview to explore responses to the IPQ-MCI. Participants correctly identified symptoms related to MCI; generally attributed MCI to aging, heredity, and abnormal brain changes; and believed MCI to be chronic, predictable, and controllable, causing little emotional distress. However, there were no consistent beliefs regarding the negative consequences of MCI or whether MCI was understandable. There were few significant correlates of beliefs. People with MCI are able to report their beliefs about their illness, suggesting that misconceptions and gaps in knowledge can be identified and addressed with nursing interventions.
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Affiliation(s)
- Feng Lin
- University of Rochester Medical Center, Rochester, NY, USA.
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15
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Hurt CS, Burns A, Brown RG, Barrowclough C. Why don't older adults with subjective memory complaints seek help? Int J Geriatr Psychiatry 2012; 27:394-400. [PMID: 21560161 DOI: 10.1002/gps.2731] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 03/10/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND Subjective memory complaints (SMCs) are common among older adults, often causing significant distress and showing strong relationships to future cognitive decline. However, low rates of help-seeking for memory complaints are well documented. Little is known about the reasons behind the decision to seek or not to seek help with memory problems. The common-sense model of illness perception proposes that the beliefs people hold about their health underlie help-seeking behaviour. The present study investigated factors underlying the decision to seek help in people with SMCs within the framework of the common-sense model of illness perception. METHODS Cognition, illness perceptions, coping styles, depression and anxiety were assessed in 98 adults with SMCs, aged 50 years and above, including 60 attending a memory clinic and 38 non-help-seekers. RESULTS Objective cognitive performance did not differ between participants who had sought help and those who had not. Logistic regression revealed that illness perceptions including social comparison and causal attributions predict help-seeking behaviour. More general coping style did not predict help-seeking. Furthermore, participants who had sought help were more likely to have had a close relative with dementia. CONCLUSIONS The results suggest that beliefs about memory, rather than objective cognitive impairment, are associated with the decision to seek help for SMCs. The findings suggest that providing education regarding memory problems, in particular challenging causal attributions, may help to encourage help-seeking in people with SMCs and improve care in the early stages of dementia.
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Affiliation(s)
- Catherine S Hurt
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
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17
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Chou PHB, Wister AV. From Cues to Action: Information Seeking and Exercise Self-Care among Older Adults Managing Chronic Illness. Can J Aging 2010. [DOI: 10.1353/cja.2006.0005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
ABSTRACTDrawing from the health belief model, cues to action have been theorized to influence health behaviours; however, few studies have examined these constructs explicitly. This study investigated the relationship between information cues to action and exercise self-care. It was hypothesized that reading about illness information, knowing about services, and consulting with others about one's illness triggers exercise self-care. The sample consisted of 879 chronically ill adults aged 50 and over, drawn from the Vancouver North Shore Self-Care Study. It was found that the odds of exercising almost doubled for readers of information about illness (compared to non-readers), after controlling for socio-demographic factors, illness context, and illness efficacy. Furthermore, knowledge of services and consultations were shown to increase the odds of exercise self-care. These findings provide support for the salience of cues to action as a pivotal theoretical construct. The implications of these findings for health promotion programs targeting persons with chronic illnesses are discussed.
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18
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Williams CL, Tappen RM, Rosselli M, Keane F, Newlin K. Willingness to be screened and tested for cognitive impairment: cross-cultural comparison. Am J Alzheimers Dis Other Demen 2010; 25:160-6. [PMID: 19949164 PMCID: PMC10845613 DOI: 10.1177/1533317509352333] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose was to describe (a) individuals' reasons for participating in cognitive screening and (b) reasons to pursue testing after screening across 4 ethnic groups: African American, Afro-Caribbean, European American, and Hispanic American. METHODS Prior to memory screening, 119 adults were interviewed regarding their thoughts about memory screening and follow-up testing. Interviews were coded and differences between ethnic groups were compared. RESULTS More African Americans and European Americans were concerned about their memory. More Hispanic Americans planned to seek professional help if needed. Hispanic Americans were most optimistic about treatment. CONCLUSIONS Future research is needed to better understand cultural factors that influence older adults' willingness to be screened for cognitive impairment and to pursue follow-up testing when recommended.
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Affiliation(s)
- Christine L Williams
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA.
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19
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What Correlates With the Intention to be Tested for Mild Cognitive Impairment (MCI) in Healthy Older Adults? Alzheimer Dis Assoc Disord 2008; 22:144-52. [PMID: 18525286 DOI: 10.1097/wad.0b013e318161103c] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Galvin JE, Fu Q, Nguyen JT, Glasheen C, Scharff DP. Psychosocial determinants of intention to screen for Alzheimer's disease. Alzheimers Dement 2007; 4:353-60. [PMID: 18790462 DOI: 10.1016/j.jalz.2007.09.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 07/05/2007] [Accepted: 09/10/2007] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is little information about how receptive older adults are to discuss memory problems with healthcare providers. Here we test the psychosocial factors explaining older adults' intention to undergo screening for Alzheimer disease (AD). METHODS A population-based, random-digit dialing strategy surveyed 1,039 older adults. The Behavioral Model of Health Services Use was used as a conceptual framework for a questionnaire testing constructs from several behavioral theories. Structural equation modeling assessed the relationship of latent variables to each construct with goodness-of-fit indices. RESULTS The study had an 82% response rate and 72% completer rate. The respondents' mean age was 62.7 +/- 10.2 years (range, 50 to 97 years). The sample was 67% women, 86% were white, and less than 40% had personal experience with AD. Respondents were nondemented (Short Blessed scores, 1.7 +/- 2.2). Predictors of intention to screen included perceived benefits (gamma = .35), knowledge of dementia (gamma = .26), self-efficacy (gamma = .23), preventive health behaviors (gamma = .17), and perceived susceptibility (gamma = .14). Knowledge was positively correlated with perceived benefits (phi = .29) and susceptibility (phi = .20). Preventive behaviors (phi = .20) were positively correlated with perceived benefits. Self-efficacy correlated positively with preventive behaviors (phi = .24) and perceived benefits (phi = .37) and negatively with perceived susceptibility (phi = -.11). Goodness-of-fit indices suggested a good fit of this model (root mean square error of approximation, .037; comparative fit index, 0.98; relative fit index; .96). DISCUSSION Older adults who have knowledge of dementia and perceive benefit from diagnosis and treatment are more likely to exhibit willingness and confidence to be tested for cognitive problems. Individuals with high self-efficacy, perceived susceptibility, and positive preventive health behaviors are also more likely to exhibit intention. These constructs can now be used to develop interventions to evaluate cognitive health in the elderly.
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Affiliation(s)
- James E Galvin
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA.
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21
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Pinto SL, Lively BT, Siganga W, Holiday-Goodman M, Kamm G. Using the Health Belief Model to test factors affecting patient retention in diabetes-related pharmaceutical care services. Res Social Adm Pharm 2007; 2:38-58. [PMID: 17138500 DOI: 10.1016/j.sapharm.2005.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Revised: 11/30/2005] [Accepted: 11/30/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diabetes is one of the deadliest and most costly diseases. Attrition rates among patients in diabetes management programs may preclude optimal success. Theoretical models, such as the Health Belief Model, may be useful for identifying factors responsible for patients' continued enrollment in such programs. OBJECTIVES (1) To design and test a reliable and valid survey instrument for assessing patients' perceptions of diabetes-related pharmaceutical care services. (2) To determine factors affecting patient retention in pharmaceutical care services. METHODS This cross-sectional exploratory study used convenience sampling to survey type 1 and 2 diabetes patients receiving pharmaceutical care at 25 Eckerd Pharmacy sites in Florida. Survey items were designed using constructs from the Health Belief Model. Reliability (Cronbach's alpha) and validity (exploratory factor analysis) were assessed. Independent t tests, Pearson's correlation coefficients, and multiple regression analysis were conducted. RESULTS Seventy usable surveys were returned (47%). In the absence of pharmaceutical care, patients felt susceptible to at least one of 8 diabetes-related conditions (hypoglycemia, hyperglycemia, diabetic foot infections, eye problems, cardiovascular risks, blood pressure problems, cholesterol problems, and kidney diseases). For these conditions, about 48% to 95% of patients perceived that their threat had reduced because of pharmaceutical care. Accordingly, more than half perceived the services as beneficial, with counseling for blood sugar monitoring rated as the most beneficial. All respondents rated the services as helpful, and 64 intended to continue regular utilization. Overall helpfulness of the service and patient retention were positively correlated (r=0.33, P<.00). Perceived susceptibility predicted perceived threat reduction (R(2)=0.22, P<.01). Perceived threat reduction, blood sugar monitoring, and overall helpfulness of the service predicted patient retention in the service (R(2)=0.41, P<.00). Factor analysis extracted 4 factors: perceived threat reduction, perceived susceptibility, perceived benefits, and blood sugar monitoring. Cronbach's alphas for the scales ranged from 0.63 to 0.91. CONCLUSION Two key constructs of the Health Belief Model influence use of diabetes-related pharmaceutical care services: perceived susceptibility and threat reduction. In an effort to increase patient retention, pharmacists need to assess patient perceptions and structure their services to address patient perceptions and concerns.
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Affiliation(s)
- Sharrel L Pinto
- Pharmacy Health Care Administration, University of Toledo College of Pharmacy, Toledo, OH 43606, USA.
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Werner P, Rosenblum S, Bar-On G, Heinik J, Korczyn A. Handwriting Process Variables Discriminating Mild Alzheimer's Disease and Mild Cognitive Impairment. J Gerontol B Psychol Sci Soc Sci 2006; 61:P228-36. [PMID: 16855035 DOI: 10.1093/geronb/61.4.p228] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study's aims were (a) to examine kinematically the handwriting process of persons with mild cognitive impairment (MCI), compared with those with mild Alzheimer's disease and healthy controls; (b) to assess the importance of these measures for the differentiation of the groups; and (c) to assess characteristics of the handwriting process across different functional tasks. Thirty-one persons with MCI, 22 with mild Alzheimer's disease, and 41 healthy controls performed functional tasks while using a computerized system. We found significant differences between the groups in almost all measures, with the MCI group assuming a position between the other groups. Temporal measures were higher and pressure was lower in more cognitively deteriorated groups. Information gathered about kinematic measures, together with cognitive functioning, allowed us to classify 69% to 72% of the participants correctly, although the classification for the MCI group was relatively poor.
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Affiliation(s)
- Perla Werner
- Department of Gerontology, University of Haifa, Mt. Carmel, Haifa 31905, Israel.
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Galvin JE, Scharff DP, Glasheen C, Fu Q. Development of a Population-based Questionnaire to Explore Psychosocial Determinants of Screening for Memory Loss and Alzheimer Disease. Alzheimer Dis Assoc Disord 2006; 20:182-91. [PMID: 16917189 DOI: 10.1097/00002093-200607000-00010] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Alzheimer disease research has focused on detecting the earliest signs of cognitive decline and efforts are ongoing to develop biomarkers and cognitive measures that reliably distinguish between nondemented and demented individuals. However, little is known about factors that may directly or indirectly influence screening behavior of older community-dwelling adults. We describe an iterative process for the development and formative evaluation of a questionnaire about dementia knowledge and screening behaviors in older adults to understand the psychosocial factors underlying intention to obtain dementia screening to profile individuals manifesting intention to undergo dementia screening compared to those who will not. The Behavioral Model of Health Services Use was used as a conceptual framework for a questionnaire with constructs from the Health Belief Model, Theory of Reasoned Action and Self-Efficacy. After pretesting, we used a random dialing strategy to test our questionnaire on a final sample of 1024 older Missourians. Internal consistency and construct validity were examined. Pretesting identified several potential problems that were improved with rewording. Cronbach alpha was greater than 0.6 (range 0.62 to 0.92) in all but one construct testing dementia knowledge, suggesting good to excellent internal consistency. Convergent (construct) validity was assessed using confirmatory factor analysis. All constructs but 3 demonstrated good validity. Addressing these issues will allow researchers to identify unique characteristics based on age, race, sex, socioeconomic differences and geographic location, and characterize barriers to screening programs to more effectively develop targeted community-based interventions.
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Affiliation(s)
- James E Galvin
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA.
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Barker WW, Luis C, Harwood D, Loewenstein D, Bravo M, Ownby R, Duara R. The Effect of a Memory Screening Program on the Early Diagnosis of Alzheimer Disease. Alzheimer Dis Assoc Disord 2005; 19:1-7. [PMID: 15764864 DOI: 10.1097/01.wad.0000155380.63231.68] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Alzheimer Disease (AD) is often diagnosed at a moderately advanced stage, even though its early detection has become increasingly important, because of the continuing development of treatments that may improve its outcome. OBJECTIVE To determine if a free memory screening program is associated with an earlier diagnosis of AD, compared with traditional referral methods, such as by physicians and family members. DESIGN, SETTING, AND PARTICIPANTS A retrospective study of 1489 consecutive patients with AD who presented to an outpatient memory disorders clinic between 1993 and 2002. Subjects were classified according to referral source (memory screening, physician, family/friend, other), and self-reported ethnicity (white non-Hispanic, white Hispanic). The associations between referral source and the presenting cognitive and behavioral status of subjects were evaluated using analysis of variance and logistic regression analyses, after controlling for potentially confounding factors. MAIN OUTCOME MEASURES Score on the Folstein Mini-Mental State Examination (MMSE), duration of cognitive symptoms, and presence of psychosis, defined as delusions and/or hallucinations. RESULTS After controlling for ethnicity, gender, and the year of diagnosis, subjects with AD, who were referred by the memory screening program, scored significantly higher at presentation on the MMSE (20.8 +/- 5.7), than those referred by physicians (18.8 +/- 6.6), family/friends (16.8 +/- 6.6), or other referral sources (15.3 +/- 7.1). Subjects with AD, referred by the memory screening program, also had a lower reported duration of illness at presentation, and a decreased frequency of psychosis compared with those referred by family/friend and other methods. Other factors related to a diagnosis of AD at a later stage included female gender, Hispanic ethnicity, and a diagnosis early in the 1993 to 2002 time period. CONCLUSIONS The memory screening program referred patients with AD to a memory clinic at an earlier phase of illness compared with traditional methods such as physician referral.
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Affiliation(s)
- Warren W Barker
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, Florida 33140, USA.
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Current awareness in geriatric psychiatry. Int J Geriatr Psychiatry 2003; 18:1149-56. [PMID: 14870737 DOI: 10.1002/gps.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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