Older adults’ attitudes and motivations towards learning about personal dementia risk and their willingness to make changes to improve their health in primary care settings

ABSTRACT

Objective

This study assessed older adults’ preferences, attitudes, and motivations to understand and change their individual risk for developing dementia via screening in primary care settings.

Method

Eighty-six community-dwelling older adults (aged 60–91 years, M = 74.03, SD = 6.83) completed measures of behavioural intent to undergo dementia risk screening, response efficacy (i.e., belief that screening is useful), negative affective responses (e.g., risk screening results making individuals more scared about the future), motivation to change risk-related behaviours, level of social support, depression, and anxiety symptomatology.

Results

Overall, participants reported positive attitudes towards dementia risk screening and risk reduction. Two ordinal logistic regressions indicated that response efficacy was a significant predictor of behavioural intent to undergo dementia risk screening, whereas self-efficacy and family history of dementia were significant predictors of motivation to change risk-related behaviours. Barriers included lack of information, motivation, and self-control. Facilitators included access to formal and informal supports, and engagement with social and non-social activities.

Conclusions

Dementia risk screening and risk reduction in primary care may be more desirable for those with a family history of dementia, high response efficacy, and high self-efficacy. Addressing barriers such as lack of information, motivation, and self-control may improve older adults’ engagement with dementia risk reduction.

KEY POINTS

What is already known about this topic:

1. Lifestyle factors can be modified to reduce dementia risk; however, an understanding of the role of motivation to change these behaviours is limited.

2. Age, sex, family history of dementia, and dementia carer experience have been linked to motivation to reduce dementia risk.

3. There is very limited understanding of people’s behavioural intent to undergo dementia risk screening in primary care.

What this topic adds:

1. Overall, older adults had positive attitudes towards dementia risk screening and risk reduction in primary care settings, and screening results mostly did not induce fear about the future.

2. Response efficacy was a significant predictor of behavioural intent to undergo dementia risk screening, whereas self-efficacy and family history of dementia were significant predictors of motivation to change risk-related behaviours.

3. Barriers to behaviour change were lack of information, motivation, and self-control. Facilitators were formal and informal supports, and social and non-social activities.

KEYWORDS:

• Attitudes
• dementia prevention
• risk screening
• motivation
• older adults
• primary care

Acknowledgements

Diana Matovic designed the study, collected and analysed the quantitative and qualitative data, and prepared the manuscript. Malene Ahern assisted with qualitative data coding and manuscript preparation. Kerry Sherman provided theoretical and study design advice relating to questionnaire use, and advice on the analysis and interpretation of findings and manuscript preparation. Carly Johnco provided advice on the ethics application and assisted with manuscript preparation. Simon Willcock provided advice on interpretation of findings and manuscript preparation. Viviana Wuthrich provided theoretical advice and co-deigned the study, and assisted with data analysis and manuscript preparation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Ethics approval did not include a provision for openly publishing these data due to the sensitive nature of depressive symptomatology, anxiety symptomatology, and social isolation data, and the potential for participants to enter identifiable information in qualitative, free-response questions. Therefore, participants did not consent to the use of their data by other researchers during the informed consent process.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/00050067.2023.2267158

Notes

1. The 40% estimate in reduced risk is based on global estimates of potential reduction in dementia prevalence if all 12 lifestyle and environmental factors were reduced in the population. Therefore, extending this logic, the questionnaire materials state that if a person eliminated all risk factors, the person could have the potential to reduce their risk by 40%. However, not all people have all the risk factors and some risk factors are more modifiable than others and so hence why participants were told that they could reduce their risk by up to 40%.

Additional information

Funding

This study was co-funded by a Medical Research Future Fund Fellowship [APP1197846] and The Ian Potter Foundation Grant awarded to Viviana Wuthrich. MRFF/NHMRC Emerging Leadership Fellowship II (2021-2025)– awarded to Viviana Wuthrich. Title: “Screening and Risk Reduction for Dementia in Primary Care”. APP1197846. Date approved 24/04/2020. The Ian Potter Foundation grant awarded to Viviana Wuthrich (2021-2026). Title “Primary care screening tool to detect, prevent and treat mental health issues for older Australians”. Date approved: 16/04/2021.