Gender differences in lay persons’ beliefs and knowledge about Alzheimer's disease (AD): A national representative study of Israeli adults

Factors associated with dementia-related stigma in British adolescents

BACKGROUND

Dementia-related stigma is a prominent barrier for people living with dementia, leading to poor well-being and social isolation. Adolescents are an under-researched group in society that may already have experience of dementia and are more susceptible to attitudinal change which makes them ideal targets for anti-stigma initiatives outlined by public health policy. For the development of evidence-based anti-stigma initiatives in adolescents, it is important to understand which socio-demographic groups are most likely to develop stigmatising attitudes and why. This study aims to identify factors of dementia-related stigma in adolescents.

METHODS

A total of 1,044 adolescents (aged 11-18 years) from across six regions of England were included in the analysis of this cross-sectional, survey-based study. Descriptive statistics and multiple regressions were employed to explore the association between demographic variables, modifiable factors of dementia-related stigma and the outcome of dementia-related stigma. A path analysis via a structural equation model was employed to test for direct and mediatory effects.

RESULTS

Multiple regression models revealed that younger adolescents, those with higher levels of contact with dementia, higher levels of empathy, higher levels of dementia knowledge, and higher affinity to older adults, are associated with more positive dementia attitudes in adolescents (p < 0.05). Within the accepted structural equation model, empathy, level of contact and dementia knowledge were key mediators of dementia-related stigma (p < 0.05).

CONCLUSION

This study highlights that modifiable factors such as level of contact, ageism, and empathy have a potentially important role in how dementia-related stigma may start to form in the adolescent years. Developing contact-based strategies that stimulate empathetic responses may be useful targets for stigma reduction initiatives for adolescents.

Seeking Dental Healthcare in the Context of COVID-19 Pandemic: A Study Examining the Health Belief Model

Background and Objectives

The main purpose of the study was to examine the factors influencing older adults' seeking dental care, in the context of coronavirus disease 2019 (COVID-19) pandemic, based on the Health Belief Model (HBM).

Research Design and Methods

Phone interviews were conducted using a structured questionnaire, among 200 older adults aged 65 and above, who are members of the Israeli largest sick fund Clalit Health Services, that were sampled through a systematic random sample. The data were collected between January 2022 and March 2022 and during September 2022.

Results

Our findings indicate that since the outbreak of COVID-19 in Israel, 61.5% and 55% of the participants reported visiting a dentist and a dental hygienist, respectively, and about a fifth of the participants have foregone care at both. Seeking dental care was associated with an increase in perceived threat, benefits, willingness to seek care, and with a decrease in perceived barriers. The HBM was found to be a suitable framework for illuminating older adults' dental behavior, which explains 43% of the variance.

Discussion and Implications

The results of the study provided first-hand findings regarding seeking dental care during the COVID-19 pandemic. These findings emphasize the importance of providing dental services with clear recommendations about dental care and appropriate protective equipment, even under conditions of health concern, to enhance oral health services utilization.

Multifactorial Memory Questionnaire: a comparison of young and older adults

The Multifactorial Memory Questionnaire (MMQ; Troyer & Rich, [2002]. Psychometric properties of a new metamemory questionnaire for older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(1), P19-P27) is a widely used measure of subjective memory consisting of three scales: Satisfaction, Ability, and Strategies. Although subjective memory complaints are prevalent across different age groups, the factor structure and psychometric properties of the MMQ have yet to be examined in young adults. Here, we independently replicated the original MMQ factor structure in N = 408 young adults (YA) recruited from undergraduate courses and N = 327 older adults (OA) and, for the first time, assessed the age-invariance of the scale using measurement invariance testing. YAs made significantly higher ratings than OAs on MMQ-Satisfaction and MMQ-Strategies, indicating greater satisfaction with their memory and greater use of strategies, but the groups were similar on MMQ-Ability. The original MMQ factor structure was replicated in OAs but not in YAs, and age invariance was not supported. Future studies seeking to compare young and older adults could therefore consider either requesting modification of the MMQ for use with young adults or using a different scale.

Factors associated with dementia attitudes in an adolescent cohort: Structural Equation Modelling

Objective

Dementia-related stigma is a key barrier to people living well with dementia, leading to social isolation and poor well-being. Adolescents represent an under-researched group that will become future carers and healthcare workers for the estimated 83.2 million people who will be living with dementia by 2030. Understanding the factors involved in dementia attitude formation in adolescents is useful for the development of evidence-based anti-stigma initiatives. This study aims to identify predictors of dementia attitudes in adolescents.

Methods

This is a cross-sectional study using secondary data analysis. 470 participants aged 12-15 years old from secondary schools in the Southeast of England, United Kingdom completed validated questionnaires relating to dementia attitudes (KIDS and Brief A-ADS) as well as demographic information. Multiple regressions were employed as well as a path analysis via a structural equation model to test for direct and mediatory effects.

Results

Multiple regression models revealed that being female, having higher levels of contact with dementia, and higher levels of empathy are positively associated with dementia attitudes in adolescents (p<0.05). Within the accepted structural equation model, empathy was a key mediator between contact and dementia attitudes.

Conclusion

This study highlights the pivotal role that contact with dementia can have in influencing dementia attitudes in adolescents with empathy serving as a mediator between contact and dementia attitudes. Interventions that use contact should consider how to stimulate empathetic responses to ultimately shape dementia attitudes.

Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer's Disease and Dementia in Qatar

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.

Association of Knowledge About Dementia with Two Dimensional Attitudes Among a Community Population in South Korea

BACKGROUND

Providing correct information about dementia and people living with dementia and improving the attitude toward the disease have important implications in overcoming prejudice and negative perceptions and strengthening the social support system. However, studies are limited about which aspects of dementia knowledge affect attitudes toward it and the influence of such knowledge on particular aspects of such attitudes.

OBJECTIVE

This study examined which part of dementia knowledge affects attitudes toward dementia and, furthermore, the influence of such knowledge on two aspects of attitudes in the general population.

METHODS

A population-based cross-sectional survey of 1,200 participants aged 20 years or older was adopted. A landline and wireless telephone survey was conducted from October 12 to October 22, 2021. The survey data included self-report questions about dementia knowledge, dementia attitudes, demographics, and family information. Multiple linear regression analysis was performed.

RESULTS

Dementia knowledge was positively associated with global dementia attitudes. In terms of the relationship between the two dimensions of dementia attitudes and knowledge, the latter displayed a significant positive association with accepting attitudes (β= 0.119, p <  0.001) but not with affective attitudes (β= 0.07, p = 0.079). Among dementia knowledge, dementia symptom/diagnosis and policy categories were positively associated with accepting attitudes (β= 0.230, p = 0.004; β= 0.340, p <  0.001).

CONCLUSION

Our study suggests that people with more dementia knowledge have more accepting attitudes toward dementia. It may be effective to continue education on dementia to improve the public accepting attitudes. However, to improve negative emotional attitudes toward dementia, various approaches beyond education may be needed.

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.

Association between having a family member with dementia and perceptions of dementia preventability

BACKGROUND

One's experience with dementia may affect their perceptions about dementia preventability, which in turn could influence preventive health behaviors. We aimed to examine how having a family history of dementia and caregiving experience are associated with perceptions about and self-efficacy for dementia preventability.

METHODS

Cross-sectional, self-administered survey. Participants reported whether they have had a family member with dementia and, among those who reported having a family member with dementia, whether they served as a caregiver. Outcomes were perceptions about the likelihood of dementia preventability, self-efficacy for dementia prevention, and benefits of specific dementia prevention strategies. Associations were assessed via partial proportional odds model for ordinal outcome variables and logistic regression for binary outcome variables.

RESULTS

Of 1,575 respondents, 71% had a family member with dementia, of which 42% served as a caregiver. People with a family member with dementia were less likely to believe that dementia is preventable (aOR = 0.75, 95% CI: 0.58, 0.96) and had lower self-efficacy for dementia prevention (aOR = 0.71, 95% CI: 0.56, 0.90). The subgroup analysis among those with caregiving experience was consistent with the primary findings, showing less belief in the likelihood of dementia preventability (aOR = 0.69, 95% CI: 0.46, 1.03) and self-efficacy (aOR = 0.75, 95% CI: 0.56, 1.00).

CONCLUSION

Having a family member with dementia is associated with unfavorable perceptions about dementia preventability. Incorporating family history of dementia into communication efforts about dementia risk reduction may help address potential barriers to preventive health behaviors.

Factors Associated With the Experience of Cognitive Training Apps for the Prevention of Dementia: Cross-sectional Study Using an Extended Health Belief Model

BACKGROUND

The prevalence and economic burden of dementia are increasing dramatically. Using information communication technology to improve cognitive functions is proven to be effective and holds the potential to serve as a new and efficient method for the prevention of dementia.

OBJECTIVE

The aim of this study was to identify factors associated with the experience of mobile apps for cognitive training in middle-aged adults. We evaluated the relationships between the experience of cognitive training apps and structural variables using an extended health belief model.

METHODS

An online survey was conducted on South Korean participants aged 40 to 64 years (N=320). General characteristics and dementia knowledge were measured along with the health belief model constructs. Statistical analysis and logistic regression analysis were performed.

RESULTS

Higher dementia knowledge (odds ratio [OR] 1.164, P=.02), higher perceived benefit (OR 1.373, P<.001), female gender (OR 0.499, P=.04), and family history of dementia (OR 1.933, P=.04) were significantly associated with the experience of cognitive training apps for the prevention of dementia.

CONCLUSIONS

This study may serve as a theoretical basis for the development of intervention strategies to increase the use of cognitive training apps for the prevention of dementia.

The impact of gender on emotional reactions, perceived susceptibility and perceived knowledge about COVID-19 among the Israeli public

BACKGROUND

The current COVID-19 outbreak is seriously affecting the lives and health of people across the globe. While gender remains a key determinant of health, attempts to address the gendered dimensions of health face complex challenges.

METHODS

In a cross-sectional study 482 participants (men=237, women=245) completed questionnaires on precautionary behaviour, perceived knowledge about COVID-19 risk factors, emotional reactions toward COVID-19 and perceived susceptibility. We examined gender differences in perceived knowledge about COVID-19 risk factors, healthy behaviours, threat perceptions and emotional responses, as well as the role of gender as a moderating factor.

RESULTS

Women reported higher levels of precautionary behaviour (t(475)=3.91, p<0.001) and more negative emotional reactions toward COVID-19 (t(475)=6.07, p<0.001). No gender differences emerged in perceived susceptibility or knowledge about COVID-19. The multiple regression model is significant and explains 30% of the variance in precautionary behaviour, which was found to be higher among women and older participants, those with higher perceived knowledge about COVID-19 risk factors and those with higher emotional reactions. Gender exhibited a significant moderating role in the relationship between perceived knowledge and precautionary behaviour (B=0.16, SE=0.07, β=0.13, p=0.02, 95% CI 0.03 to 0.30).

CONCLUSION

Women exhibited higher levels of precautionary behaviour and emotional responses.

High Prevalence and Low Awareness of Mild Cognitive Impairment in a Suburban Community in Shanghai

BACKGROUND

The prevalence of mild cognitive impairment (MCI), herein China, was without involving the suburban communities, where the awareness of MCI still remains extremely weak.

OBJECTIVE

The objective of this study is to investigate the prevalence of MCI in the Chinese residents aged ≥65 in the suburban communities of Shanghai, China, and study the awareness of MCI in terms of its symptom, prevention, and intervention.

METHODS

A total of 925 suburban community residents aged ≥65 were evaluated with a series of clinical examinations and scale questionnaire, and 600 participated in a five-dimension questionnaire survey pertaining to the awareness of MCI.

RESULTS

The prevalence of MCI was up to 29.8% and of dementia was 11.1%, respectively. A difference was observed among the three groups of dementia, MCI, and normal in each dimension of age, gender, education, being widowed, and living with the next generation (P < 0.05). The degree of cognitive impairment was linearly correlated with age (P < 0.001). The prevalence of MCI was higher in the females (P < 0.001), in the group of low educational level (P < 0.001), in the widowed residents (P < 0.01), and in those who did not live with their next generations (P < 0.01). The family's concern for MCI symptoms in the elderly accounted for 60%; the awareness rate of MCI symptoms, 25.5%; the awareness rate of MCI prevention, 15.5%; and the rate of taking MCI seniors to the doctor, 32%.

CONCLUSIONS

The prevalence of MCI in the suburban communities of Shanghai was high but the awareness of MCI was low.

Knowledge and beliefs about dementia among the general public: A preliminary report on the Cuban population

BACKGROUND

The number of people diagnosed with dementia globally has dramatically increased in recent years. The objective of this study was to explore beliefs and knowledge among the Cuban population with regard to the risk factors that may lead to dementia and the actions that may be taken to prevent it.

METHOD

In an exploratory cross-sectional study, we surveyed a total of 391 people aged between 18 and 96 years. The results were stratified by sex, age range, level of education, and contact with dementia.

RESULTS

Dementia was the fourth most worrying disease. A total of 64.5% of participants believed that the risk of dementia could be reduced, and 60% that the appropriate time to begin prevention measures is after the age of 40. Cognitive stimulation and healthy diet were more frequently cited as useful activities to reduce risk. Survey respondents reported little presence in their lifestyle of behaviours that are beneficial for reducing the risk of dementia.

CONCLUSIONS

Although dementia is an important health issue for respondents, their knowledge about disease prevention is still insufficient. The results obtained constitute a starting point for the design of policies aimed at increasing knowledge about the disease and improving prevention.

Fear about Alzheimer's disease among Israeli and German laypersons, persons with Mild Neurocognitive Disorder and their relatives: a qualitative study

OBJECTIVES

Alzheimer's disease (AD), the most common type of dementia, is one of the most feared diseases, obstructing help-seeking, and leading to discrimination. While research interest in fear of developing AD is increasing, little is known about its characterization, triggers, and consequences, especially among different cultures. In this study, we aimed at exploring and characterizing AD fear as experienced by laypersons (LP), persons with Mild Neurocognitive Disorder (MND), and their relatives, in Israel and Germany.

DESIGN

A qualitative study using focus groups (FGs) and semi-structured interviews was used. Thematic content analysis was conducted to extract key themes.

SETTING

Israeli and German not yet diagnosed people.

PARTICIPANTS

The study included a total of 130 participants (63 Israeli and 67 German participants) representing 3 groups: LP (n = 82), persons with MND (n = 28), and relatives of persons with MND (n = 20).

RESULTS

Two overarching themes were identified across groups and countries: fear of developing AD and fear of stigmatization. Other types of fear, such as fear of a person with AD, fear about the impact of a diagnosis of AD on family members, fear of becoming a caregiver, and fear of losing one's self-determination because of developing AD, were specific to a group type or country. Different types of fear were awakened by different triggers, and were dealt with different coping strategies.

A Cross-National Study of Dementia Stigma Among the General Public in Israel and Australia

BACKGROUND

Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects.

OBJECTIVE

The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia.

METHODS

A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia.

RESULTS

Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample.

CONCLUSION

Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.

Impact of the COVID-19 pandemic on stress and emotional reactions in Israel: a mixed-methods study

BACKGROUND

The COVID-19 pandemic has had a profound impact worldwide. This study sought to assess the pandemic's psychological impact on the Israeli public.

METHODS

Using mixed methods we assessed Israeli adults during the COVID-19 outbreak. In the quantitative study, participants (N=1407) completed an online battery of measures assessing psychological variables and perceived threat related to COVID-19. Statistical analyses included tests for between-group differences and Pearson correlations. The qualitative study entailed in-depth, semistructured interviews conducted by telephone (N=38).

RESULTS

The quantitative findings indicate that about 48% of the public had negative emotional reactions and 20% perceived they were liable to contract the virus. Moreover, a positive correlation was found between these feelings and the degree of perceived threat. Three major themes emerged from the qualitative study: 1) a sense of shock and chaos; 2) gradual adjustment to the new reality; and 3) fears and concerns for self and family members. The study's results revealed the following sources of participants' emotional responses and sense of threat: health concerns regarding themselves and their loved ones; employment concerns; problems with children and spouses caused by being together at home; and difficulties entailed in working at home.

CONCLUSIONS

The study reveals many of the psychological variables and perceived threats related to COVID-19 in Israel. While social distancing may make people feel safer, it can also increase their feelings of isolation, stress and frustration and cause difficulties in many life situations. The findings point to the necessity of addressing the public's perceived susceptibility and emotional reactions about COVID-19.

Dementia knowledge and its demographic correlates amongst informal dementia caregivers in Singapore

Objectives: The Dementia Knowledge Assessment Scale (DKAS) is a validated assessment tool to measure dementia knowledge. However, the factor structure of the DKAS has yet to be validated in Singapore. This study aims to investigate the DKAS factor structure amongst a sample of informal dementia caregivers in Singapore, as well as their sociodemographic correlates.Methods: A total of 282 participants were evaluated on their knowledge of dementia by an interviewer administering the DKAS. Confirmatory factor analysis (CFA) of factor models proposed by previous study yielded poor fit for our sample. Thus, an exploratory factor analysis (EFA) was conducted. Multiple linear regression was then performed to examine the sociodemographic correlates of DKAS factors.Results: EFA revealed a 23-item 3-factor model - 'misconceptions about dementia' (MD), 'caregiving considerations towards dementia' (CD) and 'dementia symptoms' (DS). Being a male caregiver and having lower educational levels were associated with poorer scores on MD and CD.Conclusion: A 3-factor model of the DKAS was found to be more appropriate with the sample in this study. Findings from this study suggests the need for more dementia literacy intervention for caregivers of dementia patients in Singapore, especially for male caregivers and those of lower education levels.

The role of social capital in COVID-19 deaths

Background

The COVID-19 pandemic has shown a continuously increasing trend with a large variation in the number of COVID-19 deaths across countries. In response, many countries have implemented non pharmaceutical methods of intervention, such as social distancing and lockdowns. This study aims to investigate the relationship of four dimensions of social capital (community attachment, social trust, family bond, and security) and several control variables with COVID-19 deaths.

Methods

We retrieved data from open access databases and a survey. COVID-19 death-related data were collected from the website “Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University”. Social capital-related data were collected from a large-scale survey that included web-based and face-to-face surveys covering 100,956 respondents across all regions/provinces/states of 37 countries in 2017. Data regarding population density, number of hospital beds, and population aged 65 or older were retrieved from the World Development Indicators (WDIs). Data on country lockdowns were obtained from the website “National responses to the 2019-20 coronavirus pandemic”. Linear regressions were applied to identify the relationship between social capital and COVID-19 deaths.

Results

We found that COVID-19 deaths were associated with social capital both positively and negatively. Community attachment and social trust were associated with more COVID-19 deaths, and family bond and security were associated with fewer deaths. COVID-19 deaths were positively associated with population density, ageing population, and interactions between four dimensions of social capital-related factors and the ageing population. Furthermore, the number of hospital beds and early lockdown policy were negatively associated with COVID-19 deaths.

Conclusions

The results indicate that the role of social capital in dynamically evolving threats, such as the current COVID-19 pandemic, is not always negative or positive. Therefore, people’s behaviour should be changed to support countries’ response to the COVID-19 threat.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10475-8.

Emotional reactions and subjective health status during the COVID-19 pandemic in Israel: the mediating role of perceived susceptibility

The general consensus is that COVID-19, the virus spreading rapidly across the globe, affects physical health but also mental health and mental well-being. This study aimed to assess the associations among emotional reactions toward COVID-19, knowledge about COVID-19, perceived susceptibility to this disease, and subjective health status. This study was a cross-sectional study conducted among 1,085 Israeli adults who completed an online survey between April 23 and May 5, 2020. The self-administered questionnaire included questions about emotional reactions to COVID-19, knowledge about COVID-19, perceived susceptibility, subjective health status, and sociodemographic variables. Participants (aged 18-96) reported high levels of emotional reactions to COVID-19. Most respondents were worried (77.4%), afraid (62.8%) or stressed (55.3%). Emotional reaction scores were higher among women than among men. In the regression model, emotional reactions were higher for older participants, those who rated their subjective health status as poorer, and those who were employed, with the final model explaining 11.6% of the variance in emotional reactions. Perceived susceptibility significantly mediated the relationship between subjective health status and emotional reactions. The high prevalence of emotional responses among women, older people and those with lower subjective health ratings points to the need for intervention programs primarily targeting these groups.

COVID-19 precautionary behavior: the Israeli case in the initial stage of the outbreak

Background

The lay public’s behavioral responses during a virus spread, such as the COVID-19, play an important role in bringing the outbreak under control, and provide insights into development of risk communication messages to the public. Therefore, this study aimed to explore the association between knowledge about COVID-19, perceived susceptibility, emotional reactions and precautionary behavior among the Israeli lay public at the beginning of the COVID-19 outbreak.

Method

A cross-sectional study was conducted among 1407 participants, aged 18 + .

Participants completed measures of knowledge about COVID-19, perceived susceptibility, emotional reactions, precautionary behavior, and socio-demographic questionnaires. A hierarchical regression model was calculated with precautionary behavior as the dependent variable.

Results

Findings indicated that precautionary behavior was higher for females, older participants, participants with higher levels of knowledge about COVID-19, and participants with greater negative emotional reactions. A negative curvilinear relationship was found between perceived susceptibility and precautionary behavior, so that the latter was highest for participants with moderate perceived susceptibility. All interaction terms were non-significant.

Conclusions

Findings suggest that in order to enhance precautionary behavior in the initial stage of a virus outbreak, it is recommended to pay attention to the public’s knowledge about the virus, perceived susceptibility and emotional reactions. Although negative feelings about the virus may motivate preventive behavior, it is important to address these feelings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09818-8.

Perceptions About and Engagement in Behaviors to Reduce the Risk of Dementia Among Adult Persons in Israel

BackgroundEngagement in behaviors aimed at reducing the risk of developing dementia is a leading recommendation in most National Dementia Strategy programs.

OBJECTIVE

In an effort to advance knowledge regarding the implementation of this recommendation, the current study examined the perceptions and engagement of the adult population in Israel regarding behaviors aimed at reducing the risk of developing dementia, and its correlates.

METHODS

A cross-sectional survey was conducted among 502 Israeli adults aged 40 and over. Approximately half of the participants (51.2%) were female, and the majority (80.1%) were Jewish.

RESULTS

Overall, while the percentage of participants reporting that the examined activities were important for brain health was moderate, percentages reporting engaging in these behaviors were low. The most important correlate of engagement in health behaviors was participants' perceptions about the importance of these behaviors for their brain health. Increased age, being Jewish, and enhanced perceived susceptibility to develop dementia were also significantly associated with increased engagement in behaviors to reduce the risk of dementia.

CONCLUSION

The results of this study emphasize the need to develop intervention programs aimed at promoting engagement in behaviors to reduce the risk of dementia development. These programs will benefit from assessing participants' perceived importance of these behaviors, and from identifying the needs of unique groups, such as older persons and those pertaining to ethno-cultural groups.

Cultural Variations in Public Beliefs about Mental Disorders: A Comparison between Tunisia and Germany

Background

In recent years there is a growing interest in public beliefs about mental disorders. Numerous representative population-based studies have been conducted around the globe, also in European countries bordering on the Mediterranean Sea. However, relatively little is known about public beliefs in countries in Northern Africa.

Objective

To fill this gap by comparing public beliefs about mental disorders in Tunisia and Germany, focusing on causal beliefs, help-seeking recommendations and treatment preferences.

Methods

Representative national population-based surveys have been conducted in Tunisia in 2012 (N = 811) and in Germany in 2011 (N = 1852), using the same interview mode and the same fully structured interview starting with a vignette depicting a person suffering from either schizophrenia or depression.

Results

In Tunisia, the public was more likely to adopt psychosocial and to reject biogenetic explanations than in Germany. Correspondingly, psychological treatments were more frequently recommended and biological ones more frequently advised against. There was also a strong inclination to share religious beliefs and to recommend seeking religious advice. Tunisians tended much more than Germans to hold moralistic views and to blame the afflicted person for his or her illness. In Tunisia, the public tended less to differentiate between schizophrenia and depression than in Germany.

Conclusion

Marked differences between Tunisia and Germany exist in public beliefs about the causes of mental disorders and their treatment, which correspond to differences in cultural orientations prevailing in these countries. Mental health professionals need to be sensitive to the particular cultural context in which they operate, in order to be able to reach those they intend to care for.

Conceptualization, measurement and correlates of dementia worry: A scoping review

PURPOSE

The combination of a growing population of older adults and increasing prevalence and awareness of dementia diagnoses suggests that dementia worry may also intensify. As a relatively new area of investigation, the dementia worry literature is growing, but variability in definitions and measurement continue. A scoping review was conducted to gather and examine existing research, as well as assist in guiding future studies in this area. The review focused on characterizing the conceptualization, measurement, and correlates of dementia worry.

METHODS

Using PubMed, CINAHL, AgeLine, and PsycINFO, a search of literature concerning dementia worry was completed.

RESULTS

A total of 45 articles examining dementia worry fulfilled the inclusion criteria. Most studies were cross-sectional (n = 39), quantitative (n = 38), and conducted in the United States (n = 22). Inconsistencies in the conceptualization, measurement, and correlates examined make it difficult to determine the meaning and true levels of dementia worry.

CONCLUSIONS

Recent attention to dementia worry has increased awareness of the basic concept and its correlates. However, the lack of unity in the definition and measurement of dementia worry impedes advancement in this research area, as well as in establishing its clinical significance.

A RE-AIM Analysis of an Intergenerational Dementia Education Program

Objectives: Children often have a lack of dementia understanding and poor attitudes toward people with dementia. Intergenerational programs are increasingly common, but the effects on knowledge and attitudes related to dementia are mixed, especially in the long-term (6 months). Using a RE-AIM framework, we quantitatively evaluated the effects of an educational dementia program (with and without an intergenerational program) on dementia attitudes in the short and long-term, and qualitatively, which elements of the program facilitated this change.

Methods: Eighty-one children (9.63 ± 0.52 years, 35 males) from three classes participated in an 8-week dementia education program and 52 also interacted with older adults through an intergenerational experience. Program reach was measured as the percentage of children who participated in the study. The Kids Insight into Dementia Survey (KIDS) was implemented to measure dementia knowledge and attitudes: efficacy and maintenance. Qualitative interviews with all participant groups informed both adoption and implementation. Cost-benefit analysis was used as a secondary outcome measure for efficacy.

Results: The program demonstrated strong levels of impact reaching 93% of school children across the three included classes. Efficacy was demonstrated by a positive change in children's dementia knowledge and attitudes immediately post program, which remained increased (as compared to baseline) 6- months post intervention; there were no differences between groups (those who interacted with older adults and those who did not). Interviews identified positive changes in children's empathy and improved community awareness. Barriers to adoption included the project scope, time constraints incurred by school terms and the management of children-to-adult ratios.

Conclusions: These findings provide the first evidence that school-based dementia education improves knowledge of and attitudes toward people with dementia long-term. We demonstrated programs such as this can be successful in both primary school and wider community settings, with support from school and community partners key to the success.

Level of understanding of Alzheimer disease among caregivers and the general population

INTRODUCTION

Understanding of Alzheimer disease (AD) is fundamental for early diagnosis and to reduce caregiver burden. The objective of this study is to evaluate the degree of understanding of AD among informal caregivers and different segments of the general population through the Alzheimer's Disease Knowledge Scale (ADKS).

PATIENTS AND METHODS

We assessed the knowledge of caregivers in different follow-up periods (less than one year, between 1 and 5 years, and over 5 years since diagnosis) and individuals from the general population. ADKS scores were grouped into different items: life impact, risk factors, symptoms, diagnosis, treatment, disease progression, and caregiving.

RESULTS

A total of 419 people (215 caregivers and 204 individuals from the general population) were included in the study. No significant differences were found between groups for overall ADKS score (19.1 vs 18.8, P = .9). There is a scarce knowledge of disease risk factors (49.3%) or the care needed (51.2%), while symptoms (78.6%) and course of the disease (77.2%) were the best understood aspects. Older caregiver age was correlated with worse ADKS scores overall and for life impact, symptoms, treatment, and disease progression (P < .05). Time since diagnosis improved caregivers' knowledge of AD symptoms (P = .00) and diagnosis (P = .05).

CONCLUSION

Assessing the degree of understanding of AD is essential to the development of health education strategies both in the general population and among caregivers.

The Impact of Age on Negative Emotional Reactions, Compliance With Health Guidelines, and Knowledge About the Virus During the COVID-19 Epidemic: A Longitudinal Study From Israel

In a longitudinal study we examined the impact of age on negative emotional reactions, compliance with health guidelines and knowledge about the virus during the COVID-19 epidemic. A total of 2509 people participated in a two-phase study: 1424 participants in the first phase (March 12-21) and 1085 participants in the second phase (April 23 to May 5). Age was categorized into 4 groups: age 18 to 30, age 31 to 40, age 41 to 50, and age 51 and over. In the first and second phase, compliance with health guidelines was highest among participants over the age of 50. Knowledge was significantly higher in the second phase than in the first among participants over age 50 and those between the ages of 40 and 50. In the second phase, knowledge did not differ by age group. Negative emotional reactions were significantly higher in the first phase than in the second. Moreover, negative emotional reactions were higher among participants up to age 30 than among all other participants. Perceived susceptibility did not differ by phase or by age group. The paper underscores the impact of age during the COVID-19 epidemic and points to the necessity of taking the needs of different age groups into consideration.

Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction

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.

Stigmatic beliefs towards persons with dementia: comparing Israeli and Greek college students

OBJECTIVES

Increasing Alzheimer's Disease (AD) awareness and decreasing stigmatic beliefs among the general public are core goals of National Dementia Strategy programs. College students are one of the most important targeted populations for achieving this goal. The aim of the current study was to examine AD public stigma among Israeli and Greek college students.

DESIGN

A cross-sectional survey was conducted among college students in Israel and Greece using vignette methodology.

PARTICIPANTS

Seven hundred and fifty three college students - 213 Israeli and 540 Greek - participated in the study.

MEASUREMENTS

Three dimensions of stigma were assessed (cognitive, emotional, and behavioral) together with health beliefs regarding AD and socio-demographic characteristics.

RESULTS

Low levels of stigma were found in both samples, with Israeli students reporting statistically significant higher levels of stigmatic beliefs than Greek students in all the dimensions, except with willingness to help. Similar to stigma in the area of mental illness, the findings in both countries supported an attributional model for AD public stigma, i.e. positive correlations were found among cognitive attributions, negative emotions, and discriminatory behaviors in both countries. Differences between the countries emerged as a significant determinant of cognitive, as well as of negative emotions and willingness to help.

CONCLUSION

Our findings might help researchers and clinicians to apply the knowledge gained in the area of mental illness to the development of effective ways of reducing AD public stigma. Moreover, they allowed us to frame the understanding of AD public stigma within a socio-cultural context.

Attitudes and completion of advance care planning: Assessing the contribution of health beliefs about Alzheimer's disease among Israeli laypersons

Objectives

The purpose of this study was to assess laypersons’ attitudes and completion of advance care planning (ACP) and to examine associations with sociodemographic characteristics and health beliefs on Alzheimer's disease.

Methods

A cross-sectional telephone survey was conducted during April and May 2017, with a sample of 514 Israeli adults, aged 18 years and above. A structured, pretested questionnaire assessing participants’ awareness, attitudes, and completion of ACP, as well as health beliefs on Alzheimer's disease (subjective knowledge, susceptibility, and worry), and sociodemographic factors, was used.

Results

Two-fifths of the participants had heard of at least one of the terms: advance directives or durable power of attorney. Overall, participants expressed positive attitudes toward ACP. Results of regression models showed that gender, religiosity, and subjective knowledge of Alzheimer's disease were statistically significant correlates of attitudes toward ACP. Adding health beliefs on Alzheimer's disease doubled the amount of the variance explained, from 3% to 6%.

Significance of results

Our results support the use of cognitive models of health behavior by assessing intra-personal beliefs and knowledge to understand ACP attitudes and completion. Specifically, we demonstrated the importance of knowledge of Alzheimer's disease for ACP attitudes, suggesting the importance of including a module on the topic to ACP interventions.

Family caregivers' and professionals' stigmatic experiences with persons with early-onset dementia: a qualitative study

OBJECTIVES

Recently, research has focused on understanding the needs of persons with early-onset dementia and their family caregivers who often experience stigmatic beliefs. However, to date, research has not provided a thorough and deep understanding of the stigma formation process and its implications for this population. Thus, the aim of the present study was to explore the stigma formation process as experienced by family members as informal caregivers of persons with early-onset dementia, and professionals as formal caregivers who are involved in the development, management and provision of services.

METHOD

We conducted three focus groups with 16 participants, including spouses of a person with early-onset dementia and professionals. The focus groups' transcripts were analysed following a thematic analysis procedure.

RESULTS

Results indicated that both family members and professionals encounter stigmatic experiences because of their association with younger persons with dementia. Lack of knowledge emerged as the main antecedent and emotional burden as the main consequence of stigma.

CONCLUSION

Stigmatic experiences emerged as a pervasive and complex phenomenon among formal and informal caregivers of persons with early-onset dementia, suggesting the need to developing a comprehensive and integrated approach to reduce them at the individual, professional and societal levels.

Level of understanding of Alzheimer disease among caregivers and the general population

INTRODUCTION

Understanding of Alzheimer disease is fundamental for early diagnosis and to reduce caregiver burden. The objective of this study is to evaluate the degree of understanding of Alzheimer disease among informal caregivers and different segments of the general population through the Alzheimer's Disease Knowledge Scale.

PATIENTS AND METHODS

We assessed the knowledge of caregivers in different follow-up periods (less than one year, between 1 and 5 years, and over 5 years since diagnosis) and individuals from the general population. Alzheimer's Disease Knowledge Scale scores were grouped into different items: life impact, risk factors, symptoms, diagnosis, treatment, disease progression, and caregiving.

RESULTS

A total of 419 people (215 caregivers and 204 individuals from the general population) were included in the study. No significant differences were found between groups for overall Alzheimer's Disease Knowledge Scale score (19.1 vs. 18.8, P = .9). There is a scarce knowledge of disease risk factors (49.3%) or the care needed (51.2%), while symptoms (78.6%) and course of the disease (77.2%) were the best understood aspects. Older caregiver age was correlated with worse Alzheimer's Disease Knowledge Scale scores overall and for life impact, symptoms, treatment, and disease progression (P < .05). Time since diagnosis improved caregivers' knowledge of Alzheimer disease symptoms (P = .00) and diagnosis (P = .05).

CONCLUSION

Assessing the degree of understanding of Alzheimer disease is essential to the development of health education strategies both in the general population and among caregivers.

Knowledge and beliefs about dementia among the general public: A preliminary report on the Cuban population

BACKGROUND

The number of people diagnosed with dementia globally has dramatically increased in recent years. The objective of this study was to explore beliefs and knowledge among the Cuban population with regard to the risk factors that may lead to dementia and the actions that may be taken to prevent it.

METHOD

In an exploratory cross-sectional study, we surveyed a total of 391 people aged between 18 and 96 years. The results were stratified by sex, age range, level of education, and contact with dementia.

RESULTS

Dementia was the fourth most worrying disease. A total of 64.5% of participants believed that the risk of dementia could be reduced, and 60% that the appropriate time to begin prevention measures is after the age of 40. Cognitive stimulation and healthy diet were more frequently cited as useful activities to reduce risk. Survey respondents reported little presence in their lifestyle of behaviours that are beneficial for reducing the risk of dementia.

CONCLUSIONS

Although dementia is an important health issue for respondents, their knowledge about disease prevention is still insufficient. The results obtained constitute a starting point for the design of policies aimed at increasing knowledge about the disease and improving prevention.

Diagnosis makes a difference: Perceptions of older persons with dementia symptoms

Background/Study Context: Employing the stereotype content model and terror management theory, we examined whether stereotypes and feelings about persons with dementia vary depending on the type of dementia diagnosis and purported causes of the dementia.

METHODS

Participants were randomly assigned to read one of four vignettes that depicted a man who consulted his doctor because of memory problems. All vignettes described the same symptoms and diagnostic tests, but each of four groups read a different result: all tests normal (Normal); Alzheimer's disease (AD); Wernicke-Korsakoff Syndrome (WKS) associated with alcohol abuse; and chronic traumatic encephalopathy (CTE) associated with head injuries from playing football in high school and college. Measures included a word fragment completion task, a stereotype content scale, and an emotions scale.

RESULTS

Results showed no differences in the number of death-related words generated in the word fragment completion task and no differences in assessment of competence across the four groups. Those in the Normal, AD, and CTE groups evaluated the man as warmer than those in the WKS group. Participants in the AD condition showed more empathy than those in the WKS group. There were no differences in pity or fear but the CTE condition produced more envy and admiration and the WKS condition produced more contempt.

CONCLUSION

These results suggest that different forms of dementia elicit varying emotional and cognitive responses.

Concern about developing Alzheimer's disease or dementia and intention to be screened: An analysis of national survey data

OBJECTIVE

Early diagnosis of Alzheimer's disease (AD) or dementia is important so that patients can express treatment preferences, subsequently allowing caregivers to make decisions consistent with their wishes. This study explored the relationship between people's concern about developing AD/dementia, likelihood to be screened/tested, if experiencing changes in cognitive status or functioning, and concerns about sharing the diagnostic information with others.

METHOD

A descriptive study was conducted using Porter Novelli's SummerStyles 2013 online survey data. Of the 6105 panelists aged 18+ who received the survey, 4033 adults responded (response rate: 66%). Chi squares were used with case-level weighting applied.

RESULTS

Almost 13% of respondents reported being very worried or worried about getting AD/dementia, with women more worried than men (p<.001), and AD/dementia caregivers more worried than other types of caregivers (p=.04). Women were also more likely than men to agree to be screened/tested if experiencing changes in memory and/or thinking (p<.001). The greater the worry, the more likely respondents would agree to be screened/tested (p<.001). Nearly 66% of respondents were concerned that sharing a diagnosis would change the way others think/feel about them, with women reporting greater concern than men (p=.003).

CONCLUSION

Findings demonstrate that level of worry about AD/dementia is associated with the reported likelihood that individuals agree to be screened/tested. This information will be useful in developing communication strategies to address public concern about AD/dementia that may increase the likelihood of screening and early detection.

Do Worries About Cognitive Functioning and Concerns About Developing Alzheimer’s Disease Affect Psychological Well-Being?

Objective: The objective of this study is to determine if cognitive worries affect psychological well-being, if these effects are long-term, and if such concerns affect well-being more so among persons with a parent having Alzheimer’s disease (AD). Method: We used structural equation models with three waves of data collected from persons ages 40 to 60 at T1. We created summative scores on five indicators of concerns about cognitive functioning and worries about dementia. Well-being measures included depression, life satisfaction, stress, and mastery. Results: We found (a) cognitive worries at Waves 1, 2, and 3 were generally associated with lower levels of psychological well-being at each of these waves; (b) there was no evidence of long-term, lagged effects, and (c) these relationships were statistically similar across groups of adult children and controls. Discussion: Because concerns about cognitive functioning and developing AD are pervasive among middle-aged and older persons, practitioners should be aware of their potentially deleterious effect on psychological well-being.

The motivation and actions of Australians concerning brain health and dementia risk reduction

ISSUE ADDRESSED

Alzheimer's disease and dementia are recognised as critical public health priorities. This study investigated intentions and behaviours concerning brain health and dementia risk reduction among Australians.

METHODS

A cross-sectional survey of 1000 persons aged 20-75 years measured knowledge, beliefs, intentions and behaviours concerning brain health and dementia. The demographic, experiential and cognitive factors associated with intentions and actions were examined.

RESULTS

Around half of respondents were motivated to improve brain health. Behaviours most often reported were mental activity (19%), physical activity (9.6%) and dietary action (6.5%). Actions were most likely among women (OR 1.59, 95% CI 1.19-2.14), those aged 60 years and over (OR 3.07, 95% CI 2.01-2.58), with university education (OR 1.67, 95% CI 1.08-2.58) or with prior contact with a person with dementia (OR 1.99, 95% CI 1.12-3.56). Both intentions and actions were associated with moderate to high knowledge, and beliefs and confidence that favoured dementia risk reduction.

CONCLUSIONS

A lower proportion of Australians reported taking action to improve brain health than who expressed intentions in this regard. Strategies are needed to improve knowledge about the range of behaviours that contribute to dementia risk reduction and to increase confidence that this outcome is personally achievable. SO WHAT? The burden of disease due to Alzheimer's disease and dementia is growing dramatically. It is essential to promote awareness that dementia is not an inevitable result of ageing and to increase understanding that action can be taken throughout the life course to promote brain health.

Worries about getting Alzheimer's: who's concerned?

The prevalence of Alzheimer's disease (AD) is projected to grow dramatically, but efforts to treat its progression have been unsuccessful. Fear of AD among older persons is greater than fear of cancer, and lingering worries about developing AD can be detrimental to well-being. Yet, much remains to be known about such worries and their precursors. This study, based on data from the Health and Retirement Survey, examines correlates of worry. Results of multivariate analyses show the following to be independent and significant correlates: present memory ratings, perceived changes in memory, personal familiarity with AD, belief that being a first-degree relative of someone with AD heightens the chance of developing AD, and age. Interaction analyses show that memory ratings and perceived changes in memory functioning are associated with worry regardless of personal familiarity. These findings will enable practitioners to identify patients and clients at risk of being worried about getting AD.

Long-term and short-term predictors of worries about getting Alzheimer's disease

Cumulative stresses associated with concerns about cognitive functioning and worries about developing Alzheimer's disease (AD) have been shown to be related to poorer health and lower psychological well-being. Among older persons, AD also generates higher levels of fear than any other disease. But much remains to be learned about predictors of worries and fears, especially from a temporal perspective. Thus, the principal objective of the current research is to examine long-term effects of self-perceptions of cognitive functioning on worries about developing AD. Data for the study are drawn from the University of Michigan's Health and Retirement Study. We use up to ten measurements of self-perceived cognitive functioning collected from 1992 to 2010 for respondents 50 years of age and older at the time of their entrance into the study. Demographics (marital status, age, education, and gender); beliefs about the role of genetics, personal knowledge of someone with AD, and their interaction; and depression and health are other variables included in the model. The data are analyzed using the full information maximum likelihood procedure and latent growth curve modeling to account for the long-term effects. The analysis shows evidence of both short-term effects of depression, age, beliefs, and the interaction of beliefs and personal familiarity and long-term effects of cognitive self-assessment on worries about getting AD. Further analyses of these relationships and inclusion of these items in other studies are recommended.

What should we know about dementia in the 21st century? A Delphi consensus study

Background

Escalating numbers of people are experiencing dementia in many countries. With increasing consumer needs, there is anticipated growth in the numbers of people providing diagnostic evaluations, treatments, and care. Ensuring a consistent and contemporary understanding of dementia across all of these groups has become a critical issue. This study aimed to reach consensus among dementia experts from English speaking countries regarding essential and contemporary knowledge about dementia.

Methods

An online Delphi study was conducted to examine expert opinion concerning dementia knowledge with three rounds of data collection. A sample of dementia experts was selected by a panel of Australian experts, including a geriatrician and three professors of aged care. Purposive selection was initially undertaken with the sample expanded through snowballing. Dementia experts (N = 19) included geriatricians, psychologists, psychiatrists, neuroscientists, dementia advocates, and nurse academics from the United Kingdom, United States, and Australia. In the first round, these participants provided open-ended responses to questions determining what comprised essential knowledge about dementia. In the second round, responses were summarised into 66 discrete statements that participants rated on the basis of importance. In the third round, a rank-ordered list of the 66 statements and a group median were provided and participants rated the statements again. The degree of consensus regarding importance ratings was determined by assessing median, interquartile range, and proportion of experts scoring above predetermined thresholds. Correlation scores were calculated for each statement after the final round to identify changes in statement scores.

Results

The Delphi experts identified 36 statements about dementia that they considered essential to understanding the condition. Statements about care for a person experiencing dementia and their care giver represented the largest response category. Other statements, for which full or very high consensus was reached, related to dementia characteristics, symptoms and progression, diagnosis and assessment, and treatment and prevention.

Conclusions

These results summarise knowledge of dementia that is considered essential across expert representatives of key stakeholder groups from three countries. This information has implications for the delivery of care to people with the condition and the development of dementia education programs.

Factors Associated With Preferences for Institutionalized Care in Elderly Persons: Comparing Hypothetical Conditions of Permanent Disability and Alzheimer's Disease

OBJECTIVE

To study the willingness to use institutional care versus home care in hypothetical situations of permanent disability and Alzheimer's disease (AD).

METHOD

A convenience sample of 484 adults aged 45 and older was obtained. Respondents were asked about their care preferences in case they were diagnosed with AD or became permanently disabled. Based on Andersen's extended behavioral model, a large group of correlates was examined.

RESULTS

Institutional care was preferred in the situation of becoming sick with AD, whereas being cared for at home by the family was preferred in a situation of permanent disability. Fear of losing one's independence and concern over burdening the family were associated with care preferences in both situations.

DISCUSSION

Although some similarities exist between the correlates for care preferences in the two distinct situations, there are noticeable differences. These are discussed and implications for practice are suggested.

Public knowledge and beliefs about dementia risk reduction: a national survey of Australians

Background

With the dramatically increasing contribution of Alzheimer’s Disease and other forms of dementia to the global burden of disease, countries are being urged to address this as a public health priority. This study investigated whether Australian adults recognise this as an important health issue, and hold beliefs and knowledge that are consistent with recommendations concerning dementia risk reduction. This research was undertaken to guide national brain health awareness and education strategies.

Methods

A cross-sectional telephone survey was undertaken of 1,003 Australians aged 20–75 years. This measured the importance placed on dementia, beliefs and confidence related to risk reduction, knowledge of risk reduction methods, and the perceived age-relevance of these. In analysis the data were stratified by sex, age, educational attainment, household income, language preference and previous exposure to dementia. Multivariable logistic regression was undertaken to identify variables independently associated with beliefs and knowledge.

Results

People aged 60 years and over identified dementia as very important (17.2%) more often than those aged 40–59 years (5.1%) or 20–39 years (2.1%). While 41.5% of respondents believed the risk of dementia could be reduced, 26.9% were very confident that they could achieve this. Mental activity (57.1%) was identified as beneficial much more often than physical activity (31.3%), healthy eating (23.3%) and other cardiovascular health behaviours. Women, people of English-speaking origin, and those having contact with a person with dementia, showed better knowledge of several health behaviours.

Conclusions

Growing attention is being given to population risk reduction to combat the dramatic increase in the burden of disease due to dementia. In Australia many people do not yet hold beliefs and knowledge that support this, which highlights the need for concerted awareness raising that dementia is not an inevitable aspect of ageing, and for education about the role of vascular health in dementia risk reduction.

Emotional reactions toward people with dementia - results of a population survey from Germany

BACKGROUND

Emotional reactions toward people with disorders are an important component of stigma process. In this study, emotional reactions of the German public toward people with dementia were analyzed.

METHODS

Analyses are based on a national mail survey conducted in 2012. Sample consists of persons aged 18 to 79 years living in private households in Germany. In all 1,795 persons filled out the questionnaire, reflecting a response rate of 78%. Respondents were asked about their emotional reactions and beliefs about dementia.

RESULTS

A vast majority of the respondents expressed pro-social reactions, i.e. they felt pity, sympathy, and the need to help a person with dementia. Dementia patients rarely evoked anger (10% or less). Between 25% and 50% of the population showed reactions indicating fear. Respondents who had contacts with a person having dementia or had cared for a dementia patient tended to show less negative reactions (fear, anger) and more pro-social reactions. Respondents who showed pronounced fearful reactions were less likely to believe that dementia patients had a high quality of life, were less willing to care for a family member with dementia at home, and were more skeptical about early detection of dementia. Comparison with the results of another study suggests that fearful reactions toward persons with dementia are much more pronounced than in the case of depression, and less pronounced than in the case of schizophrenia.

CONCLUSIONS

Fearful reactions toward people with dementia are quite common in the German general public. To reduce fear, educational programs and contact-based approaches should be considered.