1
|
Chandler CRA, Catanzaro M, Siette J. "I know now that it's something that you can do something about": Deductive thematic analysis of experiences at an arts-based dementia risk reduction exhibit. Arch Gerontol Geriatr 2024; 123:105440. [PMID: 38678743 DOI: 10.1016/j.archger.2024.105440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
Dementia is one of the leading global health crises. Despite the devastating impacts of the illness, general population knowledge pertaining to risk reduction is still limited. Previous research on the impact of dementia risk reduction campaigns has largely focused on awareness rather than behaviour change. Our research introduced an arts-based exhibit to address dementia modifiability, aiming to enhance effectiveness by providing an immersive experience for altering adults' perceptions of risk reduction and lifestyle behaviours. Interviews were conducted with adults (n = 38 [13 male, 25 female]) who attended an interactive dementia awareness and risk reduction exhibit. Data was analysed using deductive thematic analysis within the Health Belief Model framework to determine key mechanisms of behaviour change. Four key themes encompassing exhibit significance and factors underlying behaviour change were identified. Participants recounted positive experiences, particularly being engaged by the artistic aspects of the exhibit, and recorded heightened engagement in behaviours supporting dementia risk reduction post-exhibit. Areas for improvement included the need for a take-home summary and variation in formats. Participants described prior encounters with dementia and their age as factors which influenced their engagement with dementia risk reduction behaviour, with younger participants reporting lesser engagement with risk reduction information. Our research found that arts-based educational initiatives have the potential to advance public understanding and promote behavioural changes for dementia risk reduction. Our study recommends enhancing the impact of future interventions by employing innovative formats and tailoring them to varied audiences, with a specific emphasis on engaging younger individuals.
Collapse
Affiliation(s)
- Connor R A Chandler
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia
| | - Michelle Catanzaro
- Design, School of Humanities and Communication Arts, Western Sydney University, Rydalmere, NSW, 2116, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia.
| |
Collapse
|
2
|
Şener M, Küçükgüçlü Ö, Akyol MA. Does having a family member with dementia affect health beliefs about changing lifestyle and health behaviour for dementia risk reduction? Psychogeriatrics 2024; 24:868-875. [PMID: 38811353 DOI: 10.1111/psyg.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Dementia is a worldwide public health concern. Implementing lifestyle changes that target modifiable risk factors is crucial for reducing the risk of dementia. The aim of this study was to investigate the effect of having family members with dementia on individuals' health beliefs and tendencies towards adopting healthier lifestyles and behaviours. METHODS A cross-sectional, comparative study was conducted with 338 people aged 40 years and older, of whom 168 have the experience of having family members with dementia, and 170 have no such experience. Data were collected using a characteristics form, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale, and the modified Charlson comorbidity index. Descriptive statistics, Pearson's chi-square and independent t-tests, were used. RESULTS Those with family members with dementia were more likely to have greater motivation to modify their lifestyle (perceived susceptibility, severity, benefits, and cues to action) to reduce their risk of developing dementia. Additionally, they had greater perceived barriers to gain by adopting a healthy lifestyle, in contrast to those without such family members. CONCLUSION The presence of family members with dementia could be an important factor to consider when designing initiatives targeting health beliefs related to dementia prevention behaviours and lifestyle changes.
Collapse
Affiliation(s)
- Melek Şener
- SBU Izmir Bozyaka Education and Research Hospital, Karabaglar, Turkiye
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Turkiye
| | - Merve Aliye Akyol
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Turkiye
| |
Collapse
|
3
|
Meng X, Su J, Gao T, Ma D, Zhao Y, Fang S, Zhi S, Li H, Sun J. Multidomain interventions based on a life-course model to prevent dementia in at-risk Chinese older adults: A randomized controlled trial. Int J Nurs Stud 2024; 152:104701. [PMID: 38330865 DOI: 10.1016/j.ijnurstu.2024.104701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Due to the time-dependent effect of specific risk factors for dementia, multidomain interventions based on a life-course model might achieve optimal preventive effects against dementia. OBJECTIVE The purpose of this study was to investigate the effectiveness of multidomain interventions based on a life-course model of modifiable risk factors for dementia in at-risk Chinese older adults. DESIGN This was a two-arm, proof-of-concept, randomized controlled trial. SETTING AND PARTICIPANTS We randomly assigned 96 community-dwelling at-risk adults aged 60 years or older in a 1:1 ratio to either the 6-month multidomain intervention group (dementia literacy, physical activity, cognitive training, social activity and optional modules) or the control group (health education). METHODS The primary outcomes were the dementia risk score and cognitive composite Z score. The secondary outcomes included the individual components of the dementia risk score (protective and risk factors) and cognitive composite Z score (global cognition, memory, executive function and language), social isolation (loneliness, social contact, and social participation), dementia literacy and prevention belief. Linear mixed models with maximum likelihood estimation were used to calculate the outcomes between the groups over time. RESULTS The primary analyses showed that the dementia risk score was significantly lower (p < 0.001) and that the cognitive composite Z score was significantly higher (p = 0.013) in the multidomain intervention group than in the control group. Baseline characteristics did not modify the effects of the multidomain interventions (p value for interaction > 0.05). For secondary outcomes, statistically significant group × time interactions were observed for the protective (p = 0.001) and risk factors (p = 0.049), as well as in executive function (p = 0.020), loneliness (p = 0.029), dementia literacy (p < 0.001) and prevention belief (p < 0.001). CONCLUSIONS Multidomain interventions based on a life-course model are feasible and have the potential to reduce dementia risk and improve cognitive function in at-risk Chinese older adults. REGISTRATION The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2100053417).
Collapse
Affiliation(s)
- Xiangfei Meng
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jianping Su
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Xinjiang Medical University, Urumqi Municipality, Xinjiang, China
| | - Tianbao Gao
- Department of Internal Medicine, Beian No.2 People's Hospital, Beian, Heilongjiang, China
| | - Dongfei Ma
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Yanjie Zhao
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shuyan Fang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shengze Zhi
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Hongyang Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, Jilin, China.
| |
Collapse
|
4
|
Bruinsma J, Loukas VS, Kassiotis T, Heger I, Rosenberg A, Visser LNC, Mangialasche F, Fotiadis DI, Hanke S, Crutzen R. Socio-Cognitive Determinants of Lifestyle Behavior in the Context of Dementia Risk Reduction: A Population-Based Study in the Netherlands. J Alzheimers Dis 2024; 99:941-952. [PMID: 38759007 PMCID: PMC11191482 DOI: 10.3233/jad-231369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/19/2024]
Abstract
Background Unhealthy behavior increases the risk of dementia. Various socio-cognitive determinants influence whether individuals persist in or alter these unhealthy behaviors. Objective This study identifies relevant determinants of behavior associated to dementia risk. Methods 4,104 Dutch individuals (40-79 years) completed a screening questionnaire exploring lifestyle behaviors associated with dementia risk. Subsequently, 3,065 respondents who engaged in one or more unhealthy behaviors completed a follow-up questionnaire investigating socio-cognitive determinants of these behaviors. Cross-tables were used to assess the accuracy of participants' perceptions regarding their behavior compared to recommendations. Confidence Interval-Based Estimation of Relevance (CIBER) was used to identify the most relevant determinants of behavior based on visual inspection and interpretation. Results Among the respondents, 91.3% reported at least one, while 65% reported two or more unhealthy lifestyle behaviors associated to dementia risk. Many of them were not aware they did not adhere to lifestyle recommendations. The most relevant determinants identified include attitudes (i.e., lacking a passion for cooking and finding pleasure in drinking alcohol or smoking), misperceptions on social comparisons (i.e., overestimating healthy diet intake and underestimating alcohol intake), and low perceived behavioral control (i.e., regarding changing physical inactivity, altering diet patterns, and smoking cessation). Conclusions Individual-level interventions that encourage lifestyle change should focus on enhancing accurate perceptions of behaviors compared to recommendations, while strengthening perceived control towards behavior change. Given the high prevalence of dementia risk factors, combining interventions at both individual and environmental levels are likely to be the most effective strategy to reduce dementia on a population scale.
Collapse
Affiliation(s)
- Jeroen Bruinsma
- Department of Health Promotion of the Care and Public Health Research Institute at Maastricht University, Maastricht, The Netherlands
| | - Vasileios S. Loukas
- Department of Materials Science and Engineering, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology–Hellas, FORTH-BRI, Ioannina, Greece
| | - Thomas Kassiotis
- Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology – Hellas, FORTH-ICS-CBML, Heraklion, Greece
| | - Irene Heger
- Department of Psychiatry and Neuropsychology of the School for Mental Health and Neuroscience at Maastricht University, Maastricht, The Netherlands
| | - Anna Rosenberg
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Leonie N. C. Visser
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Quality of Care/Personalized Medicine, Amsterdam, The Netherlands
| | - Francesca Mangialasche
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- FINGERS Brain Health Institute, Stockholm, Sweden
- Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Solna, Sweden
| | - Dimitrios I. Fotiadis
- Department of Materials Science and Engineering, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology–Hellas, FORTH-BRI, Ioannina, Greece
| | - Sten Hanke
- Institute of eHealth at University of Applied Science at FH Joanneum, Graz, Austria
| | - Rik Crutzen
- Department of Health Promotion of the Care and Public Health Research Institute at Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
5
|
Bransby L, Rosenich E, Maruff P, Lim YY. How Modifiable Are Modifiable Dementia Risk Factors? A Framework for Considering the Modifiability of Dementia Risk Factors. J Prev Alzheimers Dis 2024; 11:22-37. [PMID: 38230714 PMCID: PMC10995020 DOI: 10.14283/jpad.2023.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/06/2023] [Indexed: 01/18/2024]
Abstract
Many risk factors for dementia, identified from observational studies, are potentially modifiable. This raises the possibility that targeting key modifiable dementia risk factors may reduce the prevalence of dementia, which has led to the development of dementia risk reduction and prevention strategies, such as intervention trials or dementia prevention guidelines. However, what has rarely been considered in the studies that inform these strategies is the extent to which modifiable dementia risk factors can (1) be identified by individuals, and (2) be readily modified by individuals. Characteristics of modifiable dementia risk factors such as readiness of identification and targeting, as well as when they should be targeted, can influence the design, or success of strategies for reducing dementia risk. This review aims to develop a framework for classifying the degree of modifiability of dementia risk factors for research studies. The extent to which these modifiable dementia risk factors could be modified by an individual seeking to reduce their dementia risk is determined, as well as the resources that might be needed for both risk factor identification and modification, and whether modification may be optimal in early-life (aged <45 years), midlife (aged 45-65 years) or late-life (aged >65 years). Finally, barriers that could influence the ability of an individual to engage in risk factor modification and, ultimately, dementia risk reduction are discussed.
Collapse
Affiliation(s)
- L Bransby
- Lisa Bransby, Turner Institute for Brain and Mental Health, 18 Innovation Walk, Clayton, VIC 3800, Australia;
| | | | | | | |
Collapse
|
6
|
Matovic D, Ahern M, Lei X, Wuthrich VM. The Influence of Traffic Lights Presentation of Dementia Risk Screening Information on Older Adults' Motivations for Risk Reduction in Primary Care Settings. Alzheimer Dis Assoc Disord 2024; 38:70-76. [PMID: 38300886 DOI: 10.1097/wad.0000000000000598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/16/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE This study assessed older adults' preferences for how to communicate dementia risk information to maximize motivation for behavior change. METHOD Eighty-nine community-dwelling older adults (aged 61 to 92 years, M=72.93, SD=6.36, 76% women) received dementia risk factor information in 2 formats: "traffic lights" (green=risk absent, amber=risk emerging, and red=risk present) or red/risk-only. Participants reported motivation to change risk-related behaviors, motivation to maintain good health behaviors, liking of the formats, categorical preference for traffic lights versus risk-only formats, reasons for preferences (open-ended), total applicable risks, and Motivation to Change Lifestyle and Health Behaviour for Dementia Risk Reduction. RESULTS Traffic lights presentation was more motivating ( Z =4.16, P <0.001), more liked ( Z =4.80, P <0.001), and preferred, N Traffic =71, N Red =14, χ 2 (1)=38.22, P <0.001, over risk-only. Self-efficacy and motivation to maintain good health behaviors were significant unique predictors of motivation to change risk-related behaviors following traffic lights presentation over age, sex, education, total applicable risks, perceived susceptibility, cues to action, and liking of the traffic lights presentation format. Themes indicated (1) traffic light presentation is informative and clear, and (2) green-light information increases self-efficacy. CONCLUSIONS Traffic light presentation increases patient motivation to reduce dementia risk. Green-light information increases self-efficacy. Maximizing motivation through information presentation can decrease dementia prevalence.
Collapse
Affiliation(s)
- Diana Matovic
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, NSW, Australia
| | | | | | | |
Collapse
|
7
|
Zakrzewski JJ, Davis JD, Gemelli ZT, Korthauer LE. Understanding Health Beliefs and Health Behaviors in Older Adults at Risk for Alzheimer's Disease. J Alzheimers Dis 2024; 99:1093-1104. [PMID: 38759001 DOI: 10.3233/jad-230977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background There are significant public health benefits to delaying the onset of Alzheimer's disease (AD) in individuals at risk. However, adherence to brain healthy behaviors is low. The Health Belief Model proposes that specific beliefs are mediators of behavior change. Objective To characterize health belief measures from the Science of Behavior Change Research Network (SBCRN) in an older adult population and associations between health beliefs, AD risk, and current health behaviors. Methods A total of 172 individuals from the Rhode Island AD Prevention Registry participated. SBCRN health belief measures included assessments of future time perspective, self-efficacy, deferment of gratification, and consideration of future consequences. Outcome measures included individual AD risk index score, dementia risk awareness, and lifestyle behaviors including physical, cognitive, and social activity. Results Participants who were older had higher scores for AD risk, lower future time perspective, and lower generalized self-efficacy (all at p < 0.001). Higher generalized self-efficacy was related to increased physical activity (p < 0.010). Higher future time perspective (p < 0.001) and generalized self-efficacy (p = 0.48) were associated with lower AD risk score. Subjective cognitive decline (SCD) was associated with lower self-efficacy, ability to delay gratification, and a less expansive future time perspective. Conclusions Greater self-efficacy and perceived future time remaining were associated with lower AD risk and greater engagement in physical activity. SCD was associated with health beliefs that may negatively affect engagement in positive brain health behaviors. Assessment of and psychoeducation about these intrapersonal health belief constructs may be important targets for behavioral interventions to reduce AD risk.
Collapse
Affiliation(s)
- Jessica J Zakrzewski
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Jennifer D Davis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| | - Zachary T Gemelli
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Laura E Korthauer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
8
|
Lin RSY, Su JJ, Kim S, Wong AKC, Chan TW, Lee SHC. Psychometric properties of the Chinese version of the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction scale (MCLHB-DRR) in Chinese community-dwelling older adults. Geriatr Nurs 2023; 54:237-245. [PMID: 37847938 DOI: 10.1016/j.gerinurse.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To assess the psychometric properties of Chinese version of Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR) scale in Chinese community-dwelling older adults. METHODS A convenience sample of 150 Chinese adults aged ≥50 was recruited from local community facilities. Reliability of MCLHB-DRR was evaluated using internal consistency and test-retest reliability over two weeks. Content validity and construct validity were assessed. Translation process followed Brislin's translation model. RESULTS After excluding two items with poor loadings, the confirmatory factor analysis revealed a good model fit (χ2/df=2.14; CFI=0.91; IFI=0.91; RMSEA=0.087). The scale exhibited good internal consistency (Cronbach's alpha = 0.865), as well as acceptable test-retest reliability (ICC=0.730). CONCLUSIONS The Chinese MCLHB-DRR showed satisfactory psychometric properties, providing valuable insights for promoting dementia risk reduction in Chinese population, considering cultural nuances that shape motivations and knowledge of lifestyle changes.
Collapse
Affiliation(s)
- Rose Sin Yi Lin
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, 255 Crittenden Blvd, Rochester, New York, 14620, USA
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Sarang Kim
- Australian Institute of Health and Welfare, 26 Thynne Street, Bruce, ACT, Australia
| | | | - Tsz Wing Chan
- Pamela Youde Nethersole Eastern Hospital, Main Block, Lok Man Rd, Chai Wan, Hong Kong
| | - Sonia Ho Ching Lee
- The Hong Kong Society for Rehabilitation, Units R9-R12, Podium, Wo Che Plaza, Wo Che Estate, Shatin, NT
| |
Collapse
|
9
|
Bartlett L, Bindoff A, Doherty K, Kim S, Eccleston C, Kitsos A, Roccati E, Alty J, King AE, Vickers JC. An online, public health framework supporting behaviour change to reduce dementia risk: interim results from the ISLAND study linking ageing and neurodegenerative disease. BMC Public Health 2023; 23:1886. [PMID: 37773122 PMCID: PMC10542675 DOI: 10.1186/s12889-023-16805-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Unmanaged cardiometabolic health, low physical and cognitive activity, poor diet, obesity, smoking and excessive alcohol consumption are modifiable health risk factors for dementia and public health approaches to dementia prevention have been called for. The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) is a dementia prevention public health study examining whether improving knowledge about modifiable dementia risk factors supports behaviour changes that reduce future dementia risk. METHODS Residents of Tasmania, Australia, aged 50 + years who joined the 10-year ISLAND study were asked to complete annual online surveys about their knowledge, motivations and behaviours related to modifiable dementia risk. ISLAND included two knowledge-based interventions: a personalised Dementia Risk Profile (DRP) report based on survey responses, and the option to do a 4-week Preventing Dementia Massive Open Online Course (PDMOOC). Longitudinal regression models assessed changes in the number and type of risk factors, with effects moderated by exposures to the DRP report and engagement with the PDMOOC. Knowledge and motivational factors related to dementia risk were examined as mediators of risk behaviour change. RESULTS Data collected between October 2019 and October 2022 (n = 3038, av. 63.7 years, 71.6% female) showed the mean number of modifiable dementia risk factors per participant (range 0 to 9) reduced from 2.17 (SD 1.24) to 1.66 (SD 1.11). This change was associated with the number of exposures to the DRP report (p = .042) and was stronger for PDMOOC participants (p = .001). The interaction between DRP and PDMOOC exposures yielded a significant improvement in risk scores (p = .004). The effect of PDMOOC engagement on behaviour change was partly mediated by increased knowledge (12%, p = .013). Self-efficacy enhanced the effect of knowledge on behaviour change, while perceived susceptibility to dementia mitigated this relationship. CONCLUSIONS The ISLAND framework and interventions, a personalised DRP report and the four-week PDMOOC, work independently and synergistically to increase dementia risk knowledge and stimulate health behaviour change for dementia risk reduction. ISLAND offers a feasible and scalable public health approach for redressing the rising prevalence of dementia.
Collapse
Affiliation(s)
- Larissa Bartlett
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.
| | - Aidan Bindoff
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Sarang Kim
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
- Australian Institute of Health and Welfare, Canberra, Australia
| | - Claire Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Alex Kitsos
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Eddy Roccati
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Anna E King
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - James C Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.
| |
Collapse
|
10
|
Siette J, Dodds L, Deckers K, Köhler S, Armitage CJ. Cross-sectional survey of attitudes and beliefs towards dementia risk reduction among Australian older adults. BMC Public Health 2023; 23:1021. [PMID: 37254125 DOI: 10.1186/s12889-023-15843-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 05/08/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Little is known about what drives older adults' motivation to change their behaviour and whether that is associated with their personal dementia risk profile. Our aims were to (i) understand what sociodemographic factors are associated with older Australians' motivation to change behaviour to reduce their dementia risk, and (ii) explore the relationship between socio-demographic factors and motivation to reduce dementia risk with health- and lifestyle-based dementia risk scores in older adults. METHODS A cross-sectional online postal or telephone survey was administered to community-dwelling older adults in New South Wales, Australia between January and March 2021. Measures included socioeconomic status, locality, and health status, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale and the lifestyle-based dementia risk score (LIBRA index). Multiple linear regression analyses were used to explore the associations for (i) sociodemographic factors and motivation to reduce dementia risk (MCLHB-DRR scales) and (ii) sociodemographic factors and motivation to reduce dementia risk with health- and lifestyle-based dementia risk (LIBRA index). RESULTS A total of 857 older adults (mean age 73.3 years, SD = 6.0, range 65-94; 70% women; 34.6% less than grade 6 education) completed the survey. Respondents reported high levels of motivation to adopt behaviour changes, agreeing on the importance of good health. Individuals who were younger were more likely to have greater motivation to modify lifestyle to reduce dementia risk and had higher perceived benefits to gain by adopting a healthy lifestyle. Dementia risk scores were moderately low (mean LIBRA index =- 2.8 [SD = 2.0], range - 5.9-3.8), indicating relatively moderate-to-good brain health. Men with low socioeconomic status and higher perceived barriers to lifestyle change had higher dementia risk scores. CONCLUSIONS Public health campaigns need to overcome motivational barriers to support reductions in dementia risk. A multifaceted and inclusive approach targeting both sociodemographic differences and impediments to brain healthy lifestyles is required to achieve genuine change. TRIAL REGISTRATION ACTRN12621000165886, Date of registration: 17/02/2021.
Collapse
Affiliation(s)
- Joyce Siette
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, NSW, 2145, Australia.
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, NSW, 2109, Australia.
| | - Laura Dodds
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, NSW, 2145, Australia
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6200 MD, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6200 MD, the Netherlands
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, M13 9PL, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, M13 9PL, UK
| |
Collapse
|
11
|
Shvedko AV, Versolker Y, Edelstein OE. Translation and Validation of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) Questionnaire among the General Israeli Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2622. [PMID: 36767987 PMCID: PMC9915287 DOI: 10.3390/ijerph20032622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The need to promote awareness of dementia prevention is broadly emphasized in Israel. Currently, there is no valid version of a Hebrew questionnaire to assess attitudes and beliefs related to dementia prevention. This study aimed to translate and validate the MCLHB-DRR questionnaire among the general Israeli population. METHODS A total sample of 328 participants between the ages of 50-83 years (mean = 58.7, SD = 6.9) were included in this study. Participants completed the online translated MCLHB-DRR questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were conducted to assess the questionnaire's validity. Internal consistency was assessed using Cronbach's alpha. RESULTS The EFA analysis revealed a seven-factor model with 27 items. One item related to perceived barriers and two items related to perceived severity were deleted. The CFA analysis confirmed a good model fit with the deleted items (χ2/df = 2.146, CFI = 0.930, TLI = 0.916, RMSEA = 0.049). Cronbach's alpha values ranged from 0.61 to 0.92. CONCLUSIONS The Hebrew MCLHB-DRR questionnaire is a valid and reliable measurement tool for assessing attitudes and beliefs related to health behaviours and lifestyle changes for dementia risk reduction in Israeli adults over the age of 50.
Collapse
|
12
|
Nemcikova M, Katreniakova Z, Nagyova I. Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia. Front Public Health 2023; 11:1104250. [PMID: 36761127 PMCID: PMC9905841 DOI: 10.3389/fpubh.2023.1104250] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Dementia is currently one of the major causes of disability and dependency among older adults worldwide. Cognitive dysfunction, neuropsychiatric symptoms, somatic complaints, and functional impairment fundamentally affect not only a person living with dementia (PLwD), but also his/her informal caregiver(s), often resulting in a high caregiver burden. A number of variables, including the caregiver's sociodemographic characteristics, the clinical characteristics of PLwD, social support, and the caregiver's personal resources determine the caregiver's burden. Objectives The aim of this study was to investigate the associations of caregiver burden in informal caregivers of PLwD with perceived social support, positive caregiving experience, and applying therapeutic communication methods. Methods The data were collected from September 2021 to February 2022 among 115 "PLwD-informal caregiver" dyads in the community settings in Slovakia. Measures included the Zarit Burden Interview (ZBI-12), the Oslo Social Support Scale (OSSS-3), the Positive Aspects of Caregiving Scale (PACS), and two questions on applying therapeutic communication methods-reminiscence and validation according to Naomi Feil. The Short IQCODE was used for assessing cognitive decline in PLwD. Pearson's and Spearman's correlations, t-tests, Chi-square, ANOVA, and linear multiple regression analyses were used to analyze the data (IBM SPSS 27). Results The mean age of informal caregivers was 54 ± 12.4 years (81.7% of women) and the mean caregiving duration was 4.8 ± 4.8 years. The mean age of PLwD was 80.5 ± 8.3 years (73.0% of women) and their Short IQCODE mean score was 4.1 ± 1.0. Lower caregiving burden was significantly associated with higher perceived social support (β = 0.33, p < 0.01), with higher positive caregiving experience (β = 0.33, p < 0.01), and higher caregiving intensity (β = 0.24, p < 0.05) among informal caregivers of PLwD. The associations between caregiver burden and applying two therapeutic communication methods were not significant. Conclusions Implementing psycho-social and educational public health interventions focused on strengthening social support and maintaining positive perceptions of caregiving can help reduce the increased risk of caregiver burden in informal caregivers of older adults with dementia.
Collapse
Affiliation(s)
- Marta Nemcikova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia
| | - Zuzana Katreniakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia,Slovak Public Health Association - SAVEZ, Kosice, Slovakia,*Correspondence: Zuzana Katreniakova ✉
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia,Slovak Public Health Association - SAVEZ, Kosice, Slovakia
| |
Collapse
|
13
|
Heger I, Deckers K, de Vugt M, Verhey F, Oenema A, van Boxtel M, Köhler S. Using mHealth for Primary Prevention of Dementia: A Proof-of-Concept Study on Usage Patterns, Appreciation, and Beliefs and Attitudes Regarding Prevention. J Alzheimers Dis 2023; 94:935-948. [PMID: 37355903 PMCID: PMC10473134 DOI: 10.3233/jad-230225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Health- and lifestyle factors account for a substantial part of all dementia cases, which opens the opportunity for primary prevention. However, the required behavioral change is complex and involves targeting multiple risk factors. mHealth interventions can potentially contribute to improving motivation in a low-cost and scalable way. OBJECTIVE To explore usage patterns, appreciation, and beliefs and attitudes regarding dementia risk reduction during the use of the MyBraincoach mobile app. METHODS Participants were community-dwelling middle-aged adults from the Netherlands and used either the standard (education) or extended (education+motivational triggers) app version for three months. Two panel studies were combined in this paper. Chi-square tests, t-tests and linear mixed models were used, adjusted for age, sex, and education. RESULTS Of all participants (n = 299, 50.2% male), 167 (55.9%) had installed the app. The most reported reason for non-use was technical problems (47%). Those who used the app were at baseline already more positive about dementia risk reduction than those who did not use the app. Of all users who completed the evaluation (n = 102), 78.4% (n = 80) stated that the app provided a positive approach towards brain health and 80.4% (n = 82) felt better informed. Younger (<60y) and lower educated participants evaluated the app most positively. CONCLUSION Usage of the app was low, but users showed more positive beliefs and attitudes regarding dementia risk reduction. Most users evaluated the app positively and stated to have gained knowledge on the topic. Improving the use of the app must keep high priority in future studies.
Collapse
Affiliation(s)
- Irene Heger
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anke Oenema
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute Maastricht, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
14
|
Gong D, Peng Y, Liu X, Zhang J, Deng M, Yang T, Yang Y. Dose health education on dementia prevention have more effects on community residents when a community physician/nurse leads it? A cross-sectional study. Front Public Health 2023; 11:1101913. [PMID: 37206874 PMCID: PMC10188958 DOI: 10.3389/fpubh.2023.1101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/04/2023] [Indexed: 05/21/2023] Open
Abstract
Background Dementia is a growing public health concern worldwide. Community residents still have limited knowledge about dementia prevention, although many sources are accessible for individuals to acquire knowledge. Methods A questionnaire-based survey was conducted in five communities in Chongqing, China, between March 2021 and February 2022. Participants were divided into three groups according to the dementia-related education they received: physician/nurse-led, mass media, and no relevant education. Covariance analysis was performed to determine the differences among the three groups in knowledge, motivation, and lifestyle, with the covariate of MoCA scores (education-adjusted). Results Of the 221 participants, 18 (8.1%) received physician/nurse-led education, 101 (45.7%) received only mass media education, and 102 (46.2%) did not receive any relevant education regarding dementia prevention. Participants who only received mass media education had a higher level of education (t = 5.567, p = 0.004) and cognitive function (t = 13.978, p < 0.001). The analysis of covariance showed that compared with participants who received no relevant education, those who received physician/nurse-led education had higher levels of knowledge, perceived benefits, and better lifestyle, and those who received mass media education had lower perceived barriers; however, higher levels of cues to action, general health motivation, self-efficacy, and lifestyle (all p < 0.05). Conclusion The popularization of dementia-related education was not ideal for communities. Physician/nurse-led education plays a vital role in providing knowledge and promoting lifestyles for dementia prevention, but may not motivate community residents. Mass media education may help encourage residents and promote their lifestyles.
Collapse
|
15
|
Li H, Zhang J, Wang L, Yang T, Yang Y. A health promoting-lifestyle prediction model for dementia prevention among chinese adults: based on the health belief model. BMC Public Health 2022; 22:2450. [PMID: 36577998 PMCID: PMC9798682 DOI: 10.1186/s12889-022-14828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/07/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND People's health belief is an important factor affecting health behavior. However, there has been little use of the health belief model (HBM) in determining the pathway effect of patients' beliefs on health behavior in dementia prevention in China. The aim of our study was to evaluate the impact of dementia prevention beliefs on health promoting lifestyle among Chinese adults. METHODS A cross-sectional study was conducted on line by convenience sampling from January to March 2020. A survey about dementia prevention knowledge, health belief of dementia prevention and health-promoting lifestyle was completed by 1201 adults in China. Data was analyzed using a structural equation model with the analysis of moment program. RESULTS The participants were aged 40.50 ± 12.72 years. About 70.3% of participants were female. The purposed model fit the data from the study well. Perceived barriers (total effect-0.322, P < 0.01) and perceived susceptibility (total effect -0.242, P < 0.01) had negative effects on lifestyle. Self-efficacy had promoting effects on lifestyle (total effect 0.207, P < 0.01). Perceived severity had positive effects both on perceived benefits (total effect 0.137, P < 0.01) and perceived barriers (total effect 0.202, P < 0.01), which had a contradictory effect in the formation of health belief. Perceived benefits, cues to action and self-efficacy played a partial mediating role between knowledge and health behavior. The belief of changing lifestyle to reduce the risk of dementia could explain 24.5% of health behavior (P < 0.05). CONCLUSIONS The findings indicate that in dementia prevention, dementia prevention health belief has important influences on health behavior. Community medical staff can develop targeted dementia prevention interventions based on the health belief model in the future.
Collapse
Affiliation(s)
- Hua Li
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China ,Department of Otolaryngology Head and Neck Surgery, The 940th Hospital of Joint Logistics Support force of Chinese People’s Liberation Army, Lanzhou, China
| | - Jinying Zhang
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China
| | - Li Wang
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China
| | - Tiantian Yang
- grid.410570.70000 0004 1760 6682School of Nursing, Army Medical University, Chongqing, China
| | - Yanni Yang
- School of Nursing, Army Medical University, Chongqing, China.
| |
Collapse
|
16
|
Ayton D, Pirotta S, Morello R, Rosenich E, Barton C, Lavale A, Pase MP, Maruff P, Yassi N, Brodtmann A, Lim YY, Barker A. Protocol for a Mixed-Methods Process Evaluation of BetterBrains: A Person-Centered Online Intervention to Delay Cognitive Decline in Adults at Risk of Dementia. J Alzheimers Dis 2022; 90:1689-1703. [PMID: 36314199 DOI: 10.3233/jad-220341] [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: 12/24/2022]
Abstract
BACKGROUND The BetterBrains Randomized Controlled Trial (RCT) will evaluate the effectiveness of an online, person-centered, risk factor management, coaching intervention in community-dwelling, healthy adults at risk of cognitive decline. Multi-component interventions are challenging to evaluate due to program complexity and personalization to individual needs and contexts. This paper describes a multi-level process evaluation conducted alongside the BetterBrains RCT. OBJECTIVE To understand how and why the BetterBrains intervention was effective or ineffective at reducing cognitive decline in healthy adults whilst considering the context in which it was implemented. METHODS 1,510 non cognitively-deteriorated community-dwelling adults aged 40-70 years old at risk of cognitive decline will be recruited and randomly assigned to the intervention or control group. All BetterBrains intervention participants, coaches, and the research team will be included in the evaluation. A mixed-methods design will be used, guided by The Framework for Implementation Fidelity and the program logic model. Data will be sourced from interviews, focus groups, surveys, BetterBrains coach notes, participant weekly check-in surveys, and audio recordings of intervention coaching sessions. Quantitative data will be analyzed via descriptive and inferential statistics and qualitative data will be analyzed using content and thematic analysis. RESULTS The process evaluation will provide information about contextual and influencing factors related to the implementation of BetterBrains and the RCT outcomes. CONCLUSION Understanding how BetterBrains was implemented and its associated impacts will inform the translation of the program into community and clinical settings, providing easy access to online, personalized dementia prevention services.
Collapse
Affiliation(s)
- Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Renata Morello
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Chris Barton
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alexandra Lavale
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Cogstate Ltd., Melbourne, VIC, Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Amy Brodtmann
- Department of Neuroscience, Central Clinical School, Monash University, The Alfred Centre, Melbourne, VIC, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Anna Barker
- Silver Chain Group, Melbourne, VIC, Australia
| | | |
Collapse
|
17
|
Zhang J, Liu X, Gong D, Peng Y, Li H, Yang Y. Health beliefs, lifestyle, and cognitive aging among Chinese community residents: A structural equation model analysis. Front Public Health 2022; 10:1028679. [PMID: 36536778 PMCID: PMC9758699 DOI: 10.3389/fpubh.2022.1028679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2022] Open
Abstract
Background Lifestyle factors may could help maintain cognitive function and reduce the risk of dementia. The application of the Health Belief Model (HBM) has been verified by incorporating lifestyle changes for dementia risk reduction; however, the influence of health beliefs on cognitive aging through lifestyle remains unknown. To facilitate research-based interventions to promote successful cognitive aging, we explored the relationship between health beliefs, lifestyle, and cognitive aging based on the HBM using path analysis. Methods This cross-sectional study recruited middle-aged and older community residents from a community health service center in Chongqing, China, through convenience sampling. Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR), Lifestyle for Dementia Risk Reduction (LDRR), and the Montreal Cognitive Assessment (MoCA) were employed to measure participants' beliefs, lifestyle, and cognitive function, respectively. The associations between the beliefs, lifestyle, and cognitive function were analyzed, and a structural equation model was constructed. Results A total of 202 participants completed the questionnaires, of whom only 17 (8.4%) were classified as having successful cognitive aging. The model demonstrated the data to have an acceptable fit and elucidated 39.3 and 18.2% of the variance in lifestyle and the grade of cognitive aging, respectively. Positive and negative beliefs had opposite effects on the grade of cognitive aging through lifestyle. Cues to action had opposite effects on the grades of cognitive aging through positive and negative beliefs; however, the total effects canceled each other out. Conclusions Positive beliefs have a positive effect on lifestyle, thereby promoting successful cognitive aging, whereas negative beliefs have a negative effect on lifestyle, thereby hindering successful cognitive aging. Health education and media publicity, as specific aspects of cues to action, can have a meaningful impact on healthy behavior and successful cognitive aging by promoting positive beliefs and controlling negative beliefs. The model suggests the strengthening and weakening of the positive and negative beliefs, respectively, of middle-aged and older community residents in the formulation of relevant public health strategies in the future, thereby enabling them to adapt to a healthy lifestyle promoting successful cognitive aging.
Collapse
|
18
|
Siette J, Dodds L, Dawes P, Richards D, Savage G, Strutt P, Ijaz K, Johnco C, Wuthrich V, Heger I, Deckers K, Köhler S, Armitage CJ. Protocol for a pre-post, mixed-methods feasibility study of the Brain Bootcamp behaviour change intervention to promote healthy brain ageing in older adults. PLoS One 2022; 17:e0272517. [PMID: 36445869 PMCID: PMC9707764 DOI: 10.1371/journal.pone.0272517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/15/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Behaviour change interventions represent key means for supporting healthy ageing and reducing dementia risk yet brief, scalable behaviour change interventions targeting dementia risk reduction in older adults is currently lacking. Here we describe the aims and design of the three-month Brain Bootcamp initiative that seeks to target multiple dementia risk and protective factors (healthy eating, physical, social and cognitive inactivity), through the use of multiple behaviour change techniques, including goal-setting for behaviour, information about health consequences and physical prompts to change behaviours that reduce dementia risk among older adults. Our secondary aim is to understand participants' views of dementia prevention and explore the acceptability and integration of this campaign into daily life. METHODS Brain Bootcamp is a pre-post feasibility trial conducted in Sydney, Australia beginning in January 2021 until late August. Participants aged ≥65 years living independently in the community (n = 252), recruited through social media and flyers, will provide information about their demographics, medical history, alcohol consumption, smoking habits, mental health, physical activity, cognitive activity, and diet to generate a dementia risk profile at baseline and assess change therein at three-month follow-up. During the intervention, participants will receive a resource pack containing their individual risk profile, educational booklet on dementia risk factors and four physical items designed to prompt physical, social and mental activity, and better nutrition. Outcome measures include change in dementia risk scores, dementia awareness and motivation. A qualitative process evaluation will interview a sample of participants on the acceptability and feasibility of the intervention. DISCUSSION This will be the first short-term multi-domain intervention targeting dementia risk reduction in older adults. Findings will generate a new evidence base on how to best support efforts targeting lifestyle changes and to identify ways to optimise acceptability and effectiveness towards brain health for older adults. TRIAL REGISTRATION NUMBER ACTRN 381046 (registered 17/02/2021); Pre-results.
Collapse
Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, New South Wales, Australia
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- * E-mail:
| | - Laura Dodds
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Piers Dawes
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Deborah Richards
- Department of Computing, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Greg Savage
- Department of Psychology, Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
| | - Paul Strutt
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
- Department of Cognitive Science, Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kiran Ijaz
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Carly Johnco
- Department of Psychology, Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
| | - Viviana Wuthrich
- Department of Psychology, Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
| | - Irene Heger
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
19
|
Kjelvik G, Rokstad AMM, Stuebs J, Thingstad P, Deckers K, Köhler S, Selbæk G. Public knowledge about dementia risk reduction in Norway. BMC Public Health 2022; 22:2046. [DOI: 10.1186/s12889-022-14433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Several modifiable lifestyle risk factors for dementia have been identified, but it is unclear how much the Norwegian public knows about the relationship between lifestyle and brain health. Therefore, this study aimed to investigate knowledge about modifiable dementia risk and protective factors and beliefs and attitudes towards dementia and dementia risk reduction in a randomly selected subsample of the Norwegian population.
Methods
The total sample (n = 1435) included individuals aged 40–70 years from four counties (Oslo, Innlandet, Nordland and Trøndelag) in Norway. Two online questionnaires were used to measure (1) awareness about dementia risk reduction and (2) an individual`s motivation to change behaviour for dementia risk reduction (MOCHAD-10).
Results
Of the participants, 70% were aware of the potential of dementia risk reduction in general. Physical inactivity (86%), cognitive inactivity (84%) and social isolation (80%) were the most frequently recognised dementia risk factors. On the other hand, diabetes (26%), coronary heart disease (19%), hearing loss (18%) and chronic kidney disease (7%) were less often recognised as dementia risk factors. Comparing men and women, the only significant difference was that women were more likely to report parents with dementia as a risk factor compared to men. Gender, age and educational differences were seen in beliefs and attitudes towards dementia prevention:women reported more negative feelings and attitudes towards dementia than men;those aged 40–49 years – more likely than older age groups – reported that ‘knowing family members with dementia’ or ‘having risk factors’ made them believe they had to change their lifestyle and behaviour.
Conclusions
The results indicate that 70% of the Norwegian public are aware of the potential for dementia risk reduction in general. However, there are major gaps in existing knowledge, particularly for cardiovascular risk factors such as hypertension, coronary heart disease, hypercholesterolemia and metabolic factors (diabetes, obesity). These findings underline the importance of further informing the Norwegian public about lifestyle-related risk and protective factors of dementia. Differences in beliefs and attitudes towards dementia risk prevention by age, gender and education require tailored public risk reduction interventions.
Collapse
|
20
|
Oliveira D, Knight H, Jones KA, Ogollah R, Orrell M. Motivation and willingness to increase physical activity for dementia risk reduction: Cross-Sectional UK survey with people aged 50 and over. Aging Ment Health 2022; 26:1899-1908. [PMID: 34607490 DOI: 10.1080/13607863.2021.1984393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
METHODS Attitudes to increasing physical activity to reduce risk of dementia were assessed in a national online survey promoted via online forums and public adverts. The Motivation to Change Behaviour for Dementia Risk Reduction (MOCHAD-10) scale examined motivation for lifestyle change. Multivariable logistic regression was used to identify the predictors of willingness and motivation to increase physical activity. RESULTS Data from 3,948 individuals showed most people were moderately/very physically active (80%). People more likely to be physically active had better health and education, were older, male, and had a partner. People willing to increase physical activity (73%) were more likely to be younger, non-White, underweight, had better health and lifestyles, and had experience caring for someone with dementia. People with higher levels of motivation to change lifestyle (MOCHAD-10 subscales) were more likely to be female, younger, in poorer physical/mental health, had lower perceived mental activity, and were a carer for someone with dementia. CONCLUSION Men and those with better health status were more physically active. Those who exercised less and those who were more motivated to increase physical activity were not necessarily able to be physically active. Multisectoral public health strategies should seek to use the high motivation levels among this group to mitigate the barriers related to physical activity for dementia risk reduction.
Collapse
Affiliation(s)
- Déborah Oliveira
- Department of Psychiatry, School of Medicine, Universidade Federal de Sao Paulo (UNIFESP), São Paulo, Brazil.,Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Holly Knight
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katy A Jones
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Reuben Ogollah
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Martin Orrell
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| |
Collapse
|
21
|
Bartlett L, Doherty K, Farrow M, Kim S, Hill E, King A, Alty J, Eccleston C, Kitsos A, Bindoff A, Vickers JC. Island Study Linking Aging and Neurodegenerative Disease (ISLAND) Targeting Dementia Risk Reduction: Protocol for a Prospective Web-Based Cohort Study. JMIR Res Protoc 2022; 11:e34688. [PMID: 35230251 PMCID: PMC8924774 DOI: 10.2196/34688] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/17/2023] Open
Abstract
Background Up to 40% of incident dementia is considered attributable to behavioral and lifestyle factors. Given the current lack of medical treatments and the projected increase in dementia prevalence, a focus on prevention through risk reduction is needed. Objective We aim to increase dementia risk knowledge and promote changes in dementia risk behaviors at individual and population levels. Methods The Island Study Linking Aging and Neurodegenerative Disease (ISLAND) is a long-term prospective, web-based cohort study with nested interventions that will be conducted over a 10-year period. Target participants (n=10,000) reside in Tasmania and are aged 50 years or over. Survey data on knowledge, attitudes, and behaviors related to modifiable dementia risk factors will be collected annually. After each survey wave, participants will be provided with a personalized dementia risk profile containing guidelines for reducing risk across 9 behavioral and lifestyle domains and with opportunities to engage in educational and behavioral interventions targeting risk reduction. Survey data will be modeled longitudinally with intervention engagement indices, cognitive function indices, and blood-based biomarkers, to measure change in risk over time. Results In the initial 12 months (October 2019 to October 2020), 6410 participants have provided baseline data. The study is ongoing. Conclusions Recruitment targets are feasible and efforts are ongoing to achieve a representative sample. Findings will inform future public health dementia risk reduction initiatives by showing whether, when, and how dementia risk can be lowered through educational and behavioral interventions, delivered in an uncontrolled real-world context. International Registered Report Identifier (IRRID) DERR1-10.2196/34688
Collapse
Affiliation(s)
- Larissa Bartlett
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Maree Farrow
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Sarang Kim
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Edward Hill
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Anna King
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Claire Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Alex Kitsos
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Aidan Bindoff
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - James C Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| |
Collapse
|
22
|
Wu J, Leong SM, Che SL, Van IK, Chuang YC. Comparisons of Dementia Knowledge and Attitudes among the Youth and Older Adults: Insights from the Construal Level Theory Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1928. [PMID: 35206122 PMCID: PMC8872372 DOI: 10.3390/ijerph19041928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 02/01/2023]
Abstract
Based on Construal Level Theory (CLT), the youth and older adults have different psychological distances towards dementia that may lead to different dementia knowledge and attitudes. A cross-sectional survey among 239 youth and 62 older adults using a two-step sampling approach in Macao aimed to examine the hypothesis. Results showed older adults had a higher score of dementia knowledge (F(1,299) = 45.692, p <0.001) but a lower score of dementia attitudes (F(1,299) = 161.887, p <0.001) compared to the youth. Age group explained the majority of the variances in the hierarchical multiple regressions for dementia knowledge (R2 = 0.178, F = 9.059, p < 0.001) and for dementia attitudes (R2 = 0.399, F = 24.233, p < 0.001), which are β = 0.47 and -0.56, respectively. Thus, the hypothesis was supported and revealed an interesting pattern of dementia knowledge and attitudes among the youth and older adults. From the CLT perspective, the study implies that reducing and bridging the psychological distance of dementia would probably be an effective strategy to increase dementia awareness among young people, and intergenerational programs may be a good option to increase community acceptance and support for people with dementia.
Collapse
Affiliation(s)
- Jianwei Wu
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macao 999078, China; (J.W.); (S.-L.C.); (I.-K.V.)
| | - Sok-Man Leong
- Research Management and Development Department, Kiang Wu Nursing College of Macau, Macao 999078, China;
| | - Sok-Leng Che
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macao 999078, China; (J.W.); (S.-L.C.); (I.-K.V.)
| | - Iat-Kio Van
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macao 999078, China; (J.W.); (S.-L.C.); (I.-K.V.)
| | - Yao-Chen Chuang
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macao 999078, China; (J.W.); (S.-L.C.); (I.-K.V.)
| |
Collapse
|
23
|
Lim YY, Ayton D, Perin S, Lavale A, Yassi N, Buckley R, Barton C, Bruns L, Morello R, Pirotta S, Rosenich E, Rajaratnam SMW, Sinnott R, Brodtmann A, Bush AI, Maruff P, Churilov L, Barker A, Pase MP. An Online, Person-Centered, Risk Factor Management Program to Prevent Cognitive Decline: Protocol for A Prospective Behavior-Modification Blinded Endpoint Randomized Controlled Trial. J Alzheimers Dis 2021; 83:1603-1622. [PMID: 34420970 DOI: 10.3233/jad-210589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Several modifiable risk factors for dementia have been identified, although the extent to which their modification leads to improved cognitive outcomes remains unclear. OBJECTIVE The primary aim is to test the hypothesis that a behavior modification intervention program targeting personalized risk factors prevents cognitive decline in community-dwelling, middle-aged adults with a family history of dementia. METHODS This is a prospective, risk factor management, blinded endpoint, randomized, controlled trial, where 1510 cognitively normal, community-dwelling adults aged 40-70 years old will be recruited. Participants will be screened for risk factors related to vascular health (including physical inactivity), mental health, sleep, and cognitive/social engagement. The intervention is an online person-centered risk factor management program: BetterBrains. Participants randomized to intervention will receive telehealth-based person-centered goal setting, motivational interviewing, and follow-up support, health care provider communication and community linkage for management of known modifiable risk factors of dementia. Psychoeducational health information will be provided to both control and intervention groups. RESULTS The primary outcome is favorable cognitive performance at 24-months post-baseline, defined as the absence of decline on one or more of the following cognitive tests: (a) Cogstate Detection, (b) Cogstate One Card Learning, (c) Cogstate One Back, and (d) Cognitive Function Instrument total score. CONCLUSION We will test the hypothesis that the BetterBrains intervention program can prevent cognitive decline. By leveraging existing community services and using a risk factor management pathway that tailors the intervention to each participant, we maximize likelihood for engagement, long-term adherence, and for preserving cognitive function in at-risk individuals.
Collapse
Affiliation(s)
- Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephanie Perin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Alexandra Lavale
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Rachel Buckley
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC Australia.,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher Barton
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Clayton, VIC, Australia
| | - Loren Bruns
- School of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia
| | - Renata Morello
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Richard Sinnott
- School of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia
| | - Amy Brodtmann
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Ashley I Bush
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Cogstate Ltd., Melbourne, VIC, Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia
| | - Anna Barker
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | |
Collapse
|
24
|
Vrijsen J, Maeckelberghe ELM, Broekstra R, de Vries JJ, Abu-Hanna A, De Deyn PP, Voshaar RCO, Reesink FE, Buskens E, de Rooij SE, Smidt N. Knowledge, health beliefs and attitudes towards dementia and dementia risk reduction among descendants of people with dementia: a qualitative study using focus group discussions. BMC Public Health 2021; 21:1344. [PMID: 34233658 PMCID: PMC8265097 DOI: 10.1186/s12889-021-11415-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background Individuals with a parental family history of dementia have an increased risk of developing dementia because they share their genes as well as their psychosocial behaviour. Due to this increased risk and their experience with dementia, they may be particularly eager to receive information regarding dementia risk reduction (DRR). This study evaluated the knowledge, beliefs and attitudes towards dementia and DRR among descendants of people with dementia. Method Using a semi-structured topic guide, three focus group discussions were conducted consisting of 12 female (80%) and 3 male (20%) descendants of people with dementia with a mean (± SD) age of 48.8 (± 12) years. Focus group discussions were audio recorded and transcribed. Each transcript was analysed thoroughly, and where appropriate, a code was generated and assigned by two researchers independently. Then, similar codes were grouped together and categorized into themes. Results The items in the topic guide could only be addressed after participants had been given the opportunity to share their experiences of having a parent with dementia. Participants were unaware or uncertain about the possibility of reducing the risk of developing dementia and therefore hesitant to assess their dementia risk without treatment options in sight. Moreover, participants indicated that their general practitioner only gave some information on heritability, not on DRR. Although participants identified a large number of modifiable risk factors as a group during the group discussions, they were eager to receive more information on dementia and DRR. In the end, participants adopted a more positive attitude towards a DRR programme and provided suggestions for the development of future DRR programmes. Conclusions Although the research aim was to evaluate the knowledge, beliefs and attitudes towards dementia and DRR, sharing experiences of having a parent with dementia seemed a prerequisite for considering participants’ own risk of developing dementia and participating in a DRR programme. Knowledge of dementia and DRR was limited. Due to unawareness of the possibility of reducing dementia risk, participants were hesitant about assessing their dementia risk. Group discussions positively changed the perception of dementia risk assessment and participants’ willingness to participate in a DRR programme. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11415-2.
Collapse
Affiliation(s)
- J Vrijsen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, the Netherlands.
| | - E L M Maeckelberghe
- Wenckebach Institute for Training and Education, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - R Broekstra
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, the Netherlands.,Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - J J de Vries
- Department of Neurology and Alzheimer Centre Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - A Abu-Hanna
- Department of Medical Informatics, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - P P De Deyn
- Department of Neurology and Alzheimer Centre Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - R C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - F E Reesink
- Department of Neurology and Alzheimer Centre Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - E Buskens
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, the Netherlands
| | - S E de Rooij
- Department of Internal Medicine & Geriatrics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - N Smidt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, the Netherlands
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Vrijsen J, Matulessij TF, Joxhorst T, de Rooij SE, Smidt N. Knowledge, health beliefs and attitudes towards dementia and dementia risk reduction among the Dutch general population: a cross-sectional study. BMC Public Health 2021; 21:857. [PMID: 33941128 PMCID: PMC8094456 DOI: 10.1186/s12889-021-10913-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background Positive health beliefs and attitudes towards dementia and dementia risk reduction may encourage adopting a healthy behaviour. Therefore, we aimed to investigate the knowledge, health beliefs and attitudes towards dementia and dementia risk reduction among the Dutch general population and its association with the intention to change health behaviours. Methods A random sample of Dutch residents (30 to 80 years) was invited to complete an online survey. We collected data on knowledge, health beliefs and attitudes towards dementia (risk reduction) and the intention to change health behaviours. Multivariable logistic regression analyses were used to obtain effect estimates. Results Six hundred fifty-five participants completed the survey. In general, participants had insufficient knowledge about dementia and dementia risk reduction. Participants had relatively high scores on general health motivation and perceived benefits, but low scores on perceived susceptibility, perceived severity, perceived barriers, cues to action and self-efficacy. Individuals with higher scores on perceived benefits and cues to action had more often the intention to change their behaviour with regard to physical activity (OR = 1.33, 95%-CI:1.11–1.58; OR = 1.13, 95%-CI:1.03–1.24, respectively) and alcohol consumption (OR = 1.30, 95%-CI:1.00–1.69; OR = 1.17, 95%-CI:1.02–1.35, respectively). Younger excessive alcohol consumers with higher perceived severity scores had more often the intention to change their alcohol consumption behaviour (OR = 2.70, 95%-CI:1.04–6.97) compared to older excessive alcohol consumers. Opposite results were found for middle-aged excessive alcohol consumers (OR = 0.81, 95%-CI:0.67–0.99). Individuals who perceived more barriers had more often the intention to change their diet (OR = 1.10, 95%-CI:1.01–1.21), but less often the intention to change their smoking behaviour (OR = 0.78, 95%-CI:0.63–0.98). Moreover, less educated individuals with higher perceived benefits scores had less often the intention to change their diet (OR = 0.78, 95%-CI:0.60–0.99), while highly educated individuals with higher perceived benefits scores had more often the intention to change their diet (OR = 1.41, 95%-CI:1.12–1.78). Conclusions The knowledge, beliefs and attitudes towards dementia and dementia risk reduction among the Dutch general population is insufficient to support dementia risk reduction. More education about dementia and dementia risk reduction is needed to improve health beliefs and attitudes towards dementia and dementia risk reduction in order to change health behaviour. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10913-7.
Collapse
Affiliation(s)
- J Vrijsen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, PO Box 30 001, FA40, 9700, RB, Groningen, the Netherlands.
| | - T F Matulessij
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, PO Box 30 001, FA40, 9700, RB, Groningen, the Netherlands
| | - T Joxhorst
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, PO Box 30 001, FA40, 9700, RB, Groningen, the Netherlands
| | - S E de Rooij
- Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - N Smidt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, PO Box 30 001, FA40, 9700, RB, Groningen, the Netherlands
| |
Collapse
|
27
|
Vrijsen J, Abu-Hanna A, Maeckelberghe EL, De Deyn PP, de Winter AF, Reesink FE, Oude Voshaar RC, Buskens E, de Rooij SE, Smidt N. Uptake and effectiveness of a tailor-made online lifestyle programme targeting modifiable risk factors for dementia among middle-aged descendants of people with recently diagnosed dementia: study protocol of a cluster randomised controlled trial (Demin study). BMJ Open 2020; 10:e039439. [PMID: 33067294 PMCID: PMC7569992 DOI: 10.1136/bmjopen-2020-039439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Descendants of patients with dementia have a higher risk to develop dementia. This study aims to investigate the uptake and effectiveness of an online tailor-made lifestyle programme for dementia risk reduction (DRR) among middle-aged descendants of people with recently diagnosed late-onset dementia. METHODS AND ANALYSIS Demin is a cluster randomised controlled trial, aiming to include 21 memory clinics of which 13 will be randomly allocated to the passive (poster and flyer in a waiting room) and 8 to the active recruitment strategy (additional personal invitation by members of the team of the memory clinic). We aim to recruit 378 participants (40-60 years) with a parent who is recently diagnosed with Alzheimer's disease or vascular dementia at one of the participating memory clinics. All participants receive a dementia risk assessment (online questionnaire, physical examination and blood sample) and subsequently an online tailor-made lifestyle advice regarding protective (Mediterranean diet, low/moderate alcohol consumption and high cognitive activity) and risk factors (physical inactivity, smoking, loneliness, cardiovascular diseases (CVD), hypertension, high cholesterol, diabetes, obesity, renal dysfunction and depression) for dementia. The primary outcome is the difference in uptake between the two recruitment strategies. Secondary outcomes are change(s) in (1) the Lifestyle for Brain Health score, (2) individual health behaviours, (3) health beliefs and attitudes towards DRR and (4) compliance to the tailor-made lifestyle advice. Outcomes will be measured at 3, 6, 9 and 12 months after baseline. The effectiveness of this online tailor-made lifestyle programme will be evaluated by comparing Demin participants to a matched control group (lifelines cohort). ETHICS AND DISSEMINATION This study has been approved by the Dutch Ministry of Health, Welfare and Sport according to the Population Screening Act. All participants have to give online informed consent using SMS-tan (transaction authentication number delivered via text message). Findings will be disseminated through peer-reviewed journals and (inter)national conferences. TRIAL REGISTRATION NUMBER NTR7434.
Collapse
Affiliation(s)
- Joyce Vrijsen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ameen Abu-Hanna
- Department of Medical Informatics, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Els Lm Maeckelberghe
- Wenckebach Institute for Training and Education, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Peter Paul De Deyn
- Department of Neurology and Alzheimer Centre Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Fransje E Reesink
- Department of Neurology and Alzheimer Centre Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sophia E de Rooij
- Medical School Twente, Medical Spectrum Twente, Enschede, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
28
|
Joxhorst T, Vrijsen J, Niebuur J, Smidt N. Cross-cultural validation of the motivation to change lifestyle and health behaviours for dementia risk reduction scale in the Dutch general population. BMC Public Health 2020; 20:788. [PMID: 32460731 PMCID: PMC7251817 DOI: 10.1186/s12889-020-08737-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/20/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study aimed to translate and validate the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale in the Dutch general population. METHODS A random sample of Dutch residents aged between 30 and 80 years old were invited to complete an online questionnaire including the translated MCLHB-DRR scale. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to assess construct validity. Cronbach's alpha was calculated to assess internal consistency. RESULTS Six hundred eighteen participants completed the questionnaire. EFA and Cronbach's alpha showed that four items were candidate for deletion. CFA confirmed that deleting these items led to an excellent fit (RMSEA = 0.043, CFI = 0.960, TLI = 0.951, χ2/df = 2.130). Cronbach's alpha ranged from 0.69 to 0.93, indicating good internal consistency. CONCLUSION The current study demonstrated that the Dutch MCLHB-DRR scale is a valid scale for assessing health beliefs and attitudes towards dementia risk reduction among Dutch adults aged between 30 and 80 years old.
Collapse
Affiliation(s)
- Tessa Joxhorst
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, The Netherlands
| | - Joyce Vrijsen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, The Netherlands.
| | - Jacobien Niebuur
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, FA40, PO Box 30 001, 9700, RB, Groningen, The Netherlands
| |
Collapse
|
29
|
Han A, Park M, Kim S, Hong H, Choi E. The use of motivational interviewing during an interdisciplinary Service-Learning activity for older adults at risk for dementia. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:206-218. [PMID: 31339477 DOI: 10.1080/02701960.2019.1647193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to develop a service-learning program based on motivational interviewing for older adults living alone and at risk for dementia. This paper focused on description and implementation of the developed program and students' preliminary outcomes as a mixed-methods pilot study. Participants were nine students in occupational therapy, physical therapy, and social work and three older adults matched to each of the three interdisciplinary student groups. Students' attitudes about community service improved. Also, participation in the program was regarded as a new useful experience that helped in realizing the importance of interprofessional collaboration, expanding knowledge about other disciplines, contributing to the community and professional development, and understanding older adults living alone. Future study should include a larger sample size and measure the program's effectiveness for both the students and older adults.
Collapse
Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Occupational Therapy, Yonsei University, Wonju, Republic of Korea
| | - Myungsook Park
- Department of Social Welfare, Sangji University, Wonju, Republic of Korea
| | - Sihyun Kim
- Department of Physical Therapy, Sangji University, Wonju, Republic of Korea
| | - Hyeon Hong
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Eunyoung Choi
- Wonju Senior Community Center, Wonju, Republic of Korea
| |
Collapse
|
30
|
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.
Collapse
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
| |
Collapse
|
31
|
Seifan A, Ganzer CA, Vermeylen F, Parry S, Zhu J, Lyons A, Isaacson R, Kim S. Development and validation of the Alzheimer's prevention beliefs measure in a multi-ethnic cohort-a behavioral theory approach. J Public Health (Oxf) 2019; 39:863-873. [PMID: 28069993 DOI: 10.1093/pubmed/fdw145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/20/2016] [Indexed: 11/12/2022] Open
Abstract
Background Understanding health beliefs and how they influence willingness will enable the development of targeted curricula that maximize public engagement in Alzheimer's disease (AD) risk reduction behaviors. Methods Literature on behavioral theory and community input was used to develop and validate a health beliefs survey about AD risk reduction among 428 community-dwelling adults. Principal component analysis was performed to assess internal consistency. Linear regression was performed to identify key predictors of Willingness to engage in AD risk reduction behaviors. Results The measure as well as the individual scales (Benefits, Barriers, Severity, Susceptibility and Social Norm) were found to be internally consistent. Overall, as Benefits and Barriers scores increased, Willingness scores also increased. Those without prior AD experience or family history had lower willingness scores. Finally, we observed an interaction between age and norms, suggesting that social factors related to AD prevention may differentially affect people of different ages. Conclusions The Alzheimer Prevention Beliefs Measure provides assessment of several health belief factors related to AD prevention. Age, Family History, Logistical Barriers and total Benefits are significant determinants of willingness to engage in AD risk reduction behaviors, such as seeing a doctor or making a lifestyle change.
Collapse
Affiliation(s)
- Alon Seifan
- Department of Neurology, Division of Memory Disorders, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, F-610, New York, NY 10065, USA
| | - Christine A Ganzer
- Hunter-Bellevue School of Nursing, Hunter College 425 E 25th Street, Rm 429, New York, NY 10010, USA
| | - Francoise Vermeylen
- College of Human Ecology, Division of Nutritional Science, Cornell University, 170 Martha Van Rensselaer Hall, Ithaca, NY 14853-4401, USA
| | - Stephen Parry
- College of Human Ecology, Division of Nutritional Science, Cornell University, 170 Martha Van Rensselaer Hall, Ithaca, NY 14853-4401, USA
| | - Jifeng Zhu
- Weill Cornell Medicine, Clinical and Translational Science Center, 407 East 61st Street, second Floor RR-214, New York, NY 10065, USA
| | - Abigail Lyons
- Weill Cornell Medicine, Clinical and Translational Science Center, 407 East 61st Street, second Floor RR-214, New York, NY 10065, USA
| | - Richard Isaacson
- Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, F-616, New York, NY 10065, USA
| | - Sarang Kim
- Australian National University College of Medicine Biology and Environment, Centre for Research on Aging, Health & Wellbeing, Canberra, ACT 2601, Australia
| |
Collapse
|
32
|
Park JE, Jeon SY, Kim SA, Kim JH, Kim SH, Lee KW, Hwang YJ, Jung G, Suk HW, Park S, Lee DY. A Multidomain Intervention for Modifying Lifestyle Habits Reduces the Dementia Risk in Community-Dwelling Older Adults: A Single-Blinded Randomized Controlled Pilot Study. J Alzheimers Dis 2019; 70:51-60. [DOI: 10.3233/jad-190016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Jee Eun Park
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Jongno Community Center for Dementia, Seoul, South Korea
| | - So Yeon Jeon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, South Korea
| | - Se An Kim
- Gachon University College of Nursing, Incheon, South Korea
| | - Jin Ha Kim
- Siheung Community Center for Dementia, Siheung, South Korea
| | - Seon Hwa Kim
- Seoul Metropolitan Center for Dementia, Seoul, South Korea
| | - Kyung Won Lee
- Jongno Community Center for Dementia, Seoul, South Korea
| | - Yun Jung Hwang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea
| | - Gijung Jung
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea
- Department of Nursing, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hye Won Suk
- Department of Psychology, Sogang University, Seoul, South Korea
| | - Saejong Park
- Korea Institute of Sport Science, Seoul, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Seoul Metropolitan Center for Dementia, Seoul, South Korea
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea
- Interdisiplinary Program in Cognitive science, Seoul National University, Seoul, South Korea
| |
Collapse
|
33
|
Oliveira D, Jones KA, Ogollah R, Ozupek S, Hogervorst E, Orrell M. Willingness to Adhere to Current UK Low-Risk Alcohol Guidelines to Potentially Reduce Dementia Risk: A National Survey of People Aged 50 and Over. J Alzheimers Dis 2019; 69:829-837. [PMID: 31127769 DOI: 10.3233/jad-181224] [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: 12/16/2022]
Abstract
BACKGROUND People over 50 are increasing their alcohol intake, potentially increasing their risk of dementia. OBJECTIVE This study investigates whether people would be willing to adhere to current United Kingdom (UK, "low-risk") alcohol guidelines to reduce dementia risk. METHODS A national cross-sectional online survey recruited a non-probabilistic sample of 3,948 individuals aged 50 and over without dementia in the UK. Self-reported willingness to comply with low-risk guidelines was predicted using logistic regression. Other relevant self-reported variables included physical health, lifestyle, and current alcohol intake. RESULTS Majority of the sample (90%, n = 3,527) reported drinking alcohol at least once a month with 23% (n = 795) exceeding the low-risk guidelines (> 14 units per week). A larger proportion of men, those who were overweight, and people without a partner reported drinking above the recommended level. Most people who consumed alcohol (n = 2,934; 74.3%) appeared willing to adhere to low-risk guidelines if they were told that their risk of having dementia could be reduced. Increased willingness was found in women (OR 1.81; CI 1.47-2.23), in people who had at least one child (OR 1.36; CI 1.09-1.70), and those who slept well (OR 1.45; CI 1.06-2.00). People who were obese (OR 0.72; CI 0.54-0.95), those who drank alcohol above limits (OR 0.13; CI 0.11-0.16), and those who were smokers (OR 0.56; CI 0.36-0.88) were less willing to adhere to current guidelines. CONCLUSION Men and people with more lifestyle risk factors for common chronic diseases (e.g., smoking, obesity, and excess alcohol consumption) are less willing to adhere to current alcohol low-risk guidelines to reduce dementia risk.
Collapse
Affiliation(s)
- Deborah Oliveira
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Innovation Park, UK.,Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Brazil
| | - Katy A Jones
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Innovation Park, UK
| | - Reuben Ogollah
- Nottingham Clinical Trials Unit, Queen's Medical Centre, Nottingham, UK
| | - Semanur Ozupek
- School of Psychology, University of Nottingham, University Park Campus, Nottingham, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Martin Orrell
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Innovation Park, UK
| |
Collapse
|
34
|
Oliveira D, Aubeeluck A, Stupple E, Kim S, Orrell M. Factor and reliability analysis of a brief scale to measure motivation to change lifestyle for dementia risk reduction in the UK: the MOCHAD-10. Health Qual Life Outcomes 2019; 17:75. [PMID: 31046782 PMCID: PMC6498554 DOI: 10.1186/s12955-019-1143-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/11/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Modifying lifestyle risk factors for dementia is a public health priority. Motivation for change is integral to the modification of health-related risk behaviours. This study investigates the psychometric properties of the previously validated tool entitled 'Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction Scale' (MCLHB-DRR) for use in the UK. METHODS A sample of 3,948 individuals aged 50 and over completed the 27-item MCLHB-DRR online. The psychometric properties of the scale were explored via Exploratory Principal Axis Factoring (PAF) with Oblimin rotation. Confirmatory Factor Analysis (CFA) was used to confirm the factor structure using chi-square (χ2), the goodness-of-fit index (GFI), the comparative fit index (CFI), the root mean square error of approximation (RMSEA) and Root Mean Square Residual (RMR) as fit indices to evaluate the model fit. Internal consistency (Cronbach α) was measured for the final scale version. RESULTS Exploratory Factor Analysis (EFA) resulted in a parsimonious 10-item, two-factor structure (5 items each, factor loadings > 0.3) that explained 52.83% of total variance. Based on the Pattern Matrix, Factor 1 was labelled "Positive Cues to Action" and Factor 2 was labelled "Negative Cues to Action". After addressing some errors in covariances, CFA showed a good fit where all fit indices were larger than 0.90 (GFI = 0.968, CFI = 0.938) and smaller than 0.08 (RMSEA = 0.072, RMR = 0.041). The standardized coefficients of Factor 1 and Factor 2 ranged from 0.30 to 0.73 and were all statistically significant (p < 0.001). The final scale showed moderate to high reliability scores (Factor 1 α = 0.809; Factor 2 α = 0.701; Overall α = 0.785). CONCLUSIONS The new MOCHAD-10 (Motivation to Change Behaviour for Dementia Risk Reduction Scale) is a short, reliable and robust two-factor, 10-item clinical tool for use in preventative health care and research to evaluate motivation to change lifestyle for dementia risk reduction.
Collapse
Affiliation(s)
- Deborah Oliveira
- Department of Psychiatry, School of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Major Maragliano, 241 - Predio Academico - Vila Mariana Mariana, São Paulo - CEP: 04017-030, São Paulo, SP Brazil
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Aimee Aubeeluck
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Ed Stupple
- Human Sciences Research Centre, College of Life and Natural Sciences, University of Derby, Derby, UK
| | - Sarang Kim
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australia
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Martin Orrell
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
35
|
Turkish Version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia Scale. J Neurosci Nurs 2019; 51:119-124. [PMID: 30801447 DOI: 10.1097/jnn.0000000000000433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This methodological study evaluates the validity and reliability of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale in Turkish. METHODS The study enrolled 220 individuals aged 40 years and older between September 2017 and June 2018. The Kendall W analysis and content validity index were used for validity; test-retest and confirmatory factor analyses were used for the reliability analysis. RESULTS The Turkish version of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale has valid content. The Cronbach α coefficient of the scale was .809, and the subscales were in the ranges of .781 to .609. A statistically significant, positive correlation was found between the test and retest scores. CONCLUSIONS These results show that the scale has validity and reliability for use in the Turkish population.
Collapse
|
36
|
McMaster M, Kim S, Clare L, Torres SJ, D'Este C, Anstey KJ. Body, Brain, Life for Cognitive Decline (BBL-CD): protocol for a multidomain dementia risk reduction randomized controlled trial for subjective cognitive decline and mild cognitive impairment. Clin Interv Aging 2018; 13:2397-2406. [PMID: 30538436 PMCID: PMC6254686 DOI: 10.2147/cia.s182046] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background With no cure for dementia and the number of people living with the condition predicted to rapidly rise, there is an urgent need for dementia risk reduction and prevention interventions. Modifiable lifestyle risk factors have been identified as playing a major role in the development of dementia; hence, interventions addressing these risk factors represent a significant opportunity to reduce the number of people developing dementia. Relatively few interventions have been trialed in older participants with cognitive decline (secondary prevention). Objectives This study evaluates the efficacy and feasibility of a multidomain lifestyle risk reduction intervention for people with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Methods This study is an 8-week, two-arm, single-blind, randomized controlled trial (RCT) of a lifestyle modification program to reduce dementia risk. The active control group receives the following four online educational modules: dementia literacy and lifestyle risk, Mediterranean diet (MeDi), cognitive engagement and physical activity. The intervention group also completes the same educational modules but receives additional practical components including sessions with a dietitian, online brain training and sessions with an exercise physiologist to assist with lifestyle modification. Results Primary outcome measures are cognition (The Alzheimer’s Disease Assessment Scale-Cognitive-Plus [ADAS-Cog-Plus]) and a composite lifestyle risk factor score for Alzheimer’s disease (Australian National University – Alzheimer’s Disease Risk Index [ANU-ADRI]). Secondary outcome measures are motivation to change lifestyle (Motivation to Change Lifestyle and Health Behaviour for Dementia Risk Reduction [MCLHB-DRR]) and health-related quality of life (36-item Short Form Health Survey [SF-36]). Feasibility will be determined through adherence to diet (Mediterranean Diet Adherence Screener [MEDAS] and Australian Recommended Food Score [ARFS]), cognitive engagement (BrainHQ-derived statistics) and physical activity interventions (physical activity calendars). Outcomes are measured at baseline, immediately post-intervention and at 3- and 6-month follow-up by researchers blind to group allocation. Discussion If successful and feasible, secondary prevention lifestyle interventions could provide a targeted, cost-effective way to reduce the number of people with cognitive decline going on to develop Alzheimer’s disease (AD) and other dementias.
Collapse
Affiliation(s)
- Mitchell McMaster
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, ACT, Australia,
| | - Sarang Kim
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, ACT, Australia,
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, ACT, Australia, .,Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychology, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
37
|
Lawless M, Augoustinos M, LeCouteur A. "Your Brain Matters": Issues of Risk and Responsibility in Online Dementia Prevention Information. QUALITATIVE HEALTH RESEARCH 2018; 28:1539-1551. [PMID: 28974154 DOI: 10.1177/1049732317732962] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The Internet has been argued to provide diverse sites for health communication and promotion, including issues that constitute major public health priorities such as the prevention of dementia. In this study, discursive psychology is used to examine how information about dementia risk prevention was presented on the websites of the most prominent English-language, nonprofit dementia organizations. We demonstrate how information about dementia risk and its prevention positions audiences as at-risk of developing dementia and constructs preventive behavior as a matter of individual responsibility. Websites represented participation in certain lifestyle practices as normative and emphasized audience members' personal responsibility for managing dementia risk. It is argued that such representations promote a moral identity in regard to brain health in which an ethic of self-responsibility is central. The implications of such identity construction in a context of increasing prevalence of dementia diagnosis are discussed.
Collapse
Affiliation(s)
- Michael Lawless
- 1 The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Amanda LeCouteur
- 1 The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
38
|
Seifan A, Isaacson R. The Alzheimer's Prevention Clinic at Weill Cornell Medical College / New York - Presbyterian Hospital: Risk Stratification and Personalized Early Intervention. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2015; 2:254-266. [PMID: 28529933 DOI: 10.14283/jpad.2015.81] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In July 2013, Weill Cornell Medical College founded the first Alzheimer's Prevention Clinic (APC) in the United States, providing direct clinical care to family members of patients with Alzheimer's disease (AD) as part of the Weill Cornell Memory Disorders Program. At the APC, patients seeking to lower their AD risk undergo a comprehensive assessment, receive a personalized plan based on rapidly evolving scientific evidence, and are followed over time using validated as well as emerging clinical and research technologies. The APC approach applies the principles of pharmacogenomics, nutrigenomics and clinical precision medicine, to tailor individualized therapies for patients. Longitudinal measures currently assessed in the clinic include anthropometrics, cognition, blood biomarkers (i.e., lipid, inflammatory, metabolic, nutritional) and genetics, as well as validated, self-reported measures that enable patients to track several aspects of health-related quality of life. Patients are educated on the fundamental concepts of AD prevention via an interactive online course hosted on Alzheimer's Universe (www.AlzU.org), which also contains several activities including validated computer-based cognitive testing. The primary goal of the APC is to employ preventative measures that lower modifiable AD risk, possibly leading to a delay in onset of future symptoms. Our secondary goal is to establish a cohort of at-risk individuals who will be primed to participate in future AD prevention trials as disease-modifying agents emerge for testing at earlier stages of the AD process. The clinical services are intended to lower concern for future disease by giving patients a greater sense of control over their brain health.
Collapse
Affiliation(s)
- A Seifan
- Department of Neurology, Division of Memory Disorders, Weill Cornell Medical College / New York-Presbyterian Hospital, New York, NY, USA
| | - R Isaacson
- Department of Neurology, Division of Memory Disorders, Weill Cornell Medical College / New York-Presbyterian Hospital, New York, NY, USA
| |
Collapse
|