A 2-Study Psychometric Evaluation of the Modified Dementia Worry Scale

On the Measurement of Aging Anxiety: Comparative Validity of Two Popular Measures Among Older Adults

Aging anxiety is a distinct form of fear characterized by negative feelings associated with growing older. This study directly compared two common measures of aging anxiety within an older adult sample. Participants completed the Anxiety about Aging Scale, the Personal Anxiety Toward Aging Scale and several related constructs including ageism, expectations regarding aging, dementia worry, and death anxiety. The two measures significantly and strongly associated with one another. The Anxiety about Aging Scale (AAS) showed evidence of convergent validity through significant and strong correlations with ageism, expectations regarding aging, and death anxiety, and a moderate correlation with dementia worry. The Personal Anxiety Toward Aging Scale (PAAS) also showed evidence of convergent validity through strong correlations with expectations regarding aging and death anxiety, and moderate correlations with ageism and dementia worry. Factor analysis showed a better model fit for the AAS. Key findings lend support for the AAS as a psychometrically stronger measure than the PAAS for older adult assessment.

Validating the Hebrew Version of the Modified Dementia Worry Scale (H-MDWS)

The body of knowledge regarding dementia worry - people's sense of threat about developing dementia - is still limited. Additional studies are essential to better understand levels of dementia worry and its correlates, especially in cross-cultural contexts. To reach this goal, it is critical to use structured and valid measures to assess dementia worry and to verify these measures in different languages. Therefore, the aim of the current study was to evaluate the psychometric properties of the Hebrew version of the Modified Dementia Worry Scale (the H-MDWS). A cross-sectional study using an online survey was conducted with 368 Israeli laypeople who were 18 years of age or older (53% women, 76% Jewish, mean age = 40, average years of education = 14). In addition to the H-MDWS, participants were asked to report their fear of Alzheimer's disease (using a dichotomous single item), stigma, health anxiety, and demographic characteristics. Reliability analyses showed that the Cronbach's alpha for the H-MDWS was excellent (α = 0.95). The results of the factor analysis demonstrated that the scale has a unidimensional structure, explaining over 66% of the variance. In addition, we found significant correlations between fear of developing Alzheimer's disease, stigma, and health anxiety, on the one hand, and the H-MDWS on the other. The H-MDWS is a reliable and valid tool for assessing dementia worry. The validation of the tool not only allows expanding the body of knowledge related to dementia worry, but will also allow professionals and caregivers to identify people who are at risk of reporting dementia worry and develop interventions accordingly.

Anticipated suicidal and death ideation in response to an imagined dementia diagnosis: A qualitative study

Alzheimer's disease and related dementias are prevalent, highly impactful, and feared diagnoses. A mixed methods study using semi-structured interviews was conducted to clarify causes of dementia-related anxiety. Fifty community-dwelling adults aged 58 to 89 (M = 70.92, SD = 6.08) were recruited from a university participant registry and Memory Clinic; none had dementia diagnoses. Analyses revealed that 42% (n = 21) of participants anticipated suicidal or death ideation if diagnosed with dementia. Among participants endorsing anticipated suicidal or death ideation, responses ranged from active, specific plans, including interest in physician-assisted suicide, to more passive wishes to hasten death rather than continue to live with dementia. Within reports of both anticipated suicidal and death ideation, three subthemes emerged. Participants reported concerns about becoming a burden to others, the devaluation of life/loss of self with dementia, and the desire for (and anticipated thwarting of) personal control as factors contributing to their anticipated responses to a dementia diagnosis. Statements of anticipated suicidal and death ideation were contingent on a dementia diagnosis and may reflect errors in affective forecasting. Nevertheless, given the prevalence of dementias and older adults' elevated rates of suicide, the intersection of these two public health issues warrants greater attention.

Profiles in Dementia-Related Anxiety: A Latent Profile Analysis

OBJECTIVES

Dementia-related anxiety (DRA) is the concern about current or future cognitive decline and potential diagnosis of Alzheimer's disease or related dementias (ADRD). Existing research suggests that DRA likely develops due to diverse reasons (e.g., family ADRD history, self-perceived risk, and health-related anxiety), and approaches to managing DRA likely differ as well (e.g., future planning). This study aimed to identify profiles in DRA.

METHOD

In a cross-sectional study, a convenience sample of U.S. adults ranging in age from 18 to 82 (N = 492, Mage = 49.25, standard deviation [SDage] = 15.43) completed online assessments of characteristics associated with DRA. Latent profile analysis was used to uncover distinct DRA profiles and promote understanding of individual characteristics associated with varying levels of DRA; multinomial regression assessed if the profiles are further distinguished by covariates.

RESULTS

The resulting four-profile model reveals profile differences are largely due to DRA, self-perceived ADRD risk, and preparedness for future care needs; health-related anxiety, age, ADRD exposure, and anticipated ADRD stigma contribute to profile differences as well. Profiles of the youngest and oldest groups reported the lowest and highest levels of preparedness for future care, along with the lowest DRA and self-perceived risk. Several covariates, particularly those assessing general psychological functioning, were also related to profile membership.

DISCUSSION

The resulting profiles point to several factors associated with elevated anxiety about ADRD, which do not fully match the risk factors for ADRD.