Factors Influencing Decisions to Make Dementia Risk-Reducing Lifestyle Changes Elle A. Moore, Danica Kulibert, Alexandria R. Ebert, Susan H. McFadden University of Wisconsin Oshkosh

Dementia General term describing progressive loss of cognitive abilities, including: Memory Attention Decision-making Communication Orientation to time and place Alzheimer’s Disease is the most commonly known form of dementia Currently 5.4 million in U.S. with Alzheimer’s Disease 13.8 million projected to have dementia in 2050 unless preventative measures are taken Alzheimer’s Association (2016); Hebert, Weuve, Scherr, & Evans (2013)

What increases dementia risk? 6-7% of early onset Alzheimer’s Disease attributed to genetics Modifiable vs. Nonmodifiable factors Campion et al. (1999); Polidori et al. (2010)

Dementia Prevention and Treatment Prevention of Dementia Maintenance of physical activity throughout life Diet to reduce hypertension (high fruit/vegetable consumption, low red meat consumption) Socialization and cognitive activities associated with slower cognitive decline Treatment of Dementia There is no cure for dementia. Cholinesterase inhibitors: little evidence of long-term gain Psychotropic medication for behavioral and psychological symptoms: Not recommended Behavioral management techniques Modifying sensory stimulation Evidence-based programs (i.e., arts initiatives) Barnard et al. (2015); Bherer et al. (2013); Overshott & Burns (2005); Polidori et al. (2010); Simons et al. (2006); Woods et al. (2012)

Primary Objective What factors increase the likelihood of making lifestyle changes in order to reduce the risk of developing dementia?

Current Study Explored the influence of variables on decisions to adopt dementia risk-reducing lifestyle changes: Gender Age Education level Exposure to persons with dementia (family/friends with dementia) Level of concern about caring for a loved one with dementia Tacit (practical) dementia knowledge Explicit (factual) dementia knowledge

Methods: Participants and Procedure N = 616 adults 76.3% female, 23.7% male Mage = 46.03 years, SDage = 16.80 years Majority completed some college or obtained a Bachelor’s or graduate degree (90%) 51.60% reported knowing a family member/friend with dementia Wisconsin Residents Recruited via internet-based platforms and community outreach Survey Demographic information Knowledge, attitudes, and concerns regarding dementia Lifestyle changes

Measure: Dementia Survey Exposure “Do any of your family members or friends have any form of dementia? (yes/no) Concern “How concerned are you that you may someday have to provide for or care for someone with dementia?” (Not at all, Somewhat, Very Concerned) Knowledge Tacit (practical): 20 items “People with dementia can feel when others are kind to them.” Explicit (factual): 22 items “Only older adults develop dementia.” ADD NUMBER OF ITEMS PER CATEGORY

Measure: Lifestyle Changes Responded to question asking: “Have you made any changes in your diet or lifestyle to help reduce your risk of getting dementia? If yes, what have you done?” Responses coded based on themes that emerged from participants’ responses Six themes describing lifestyle changes: Dietary/Nutritional, Physical Activity, Mental Stimulation/Learning, Sleep, Supplements, Miscellaneous

Number of Lifestyle Changes

Types of Lifestyle Changes

Results: Logistic Regression When including sex, education, age, concern for caring for a family member with dementia, exposure to persons with dementia, and dementia knowledge, the model explained 23.80% of the variance in making lifestyle changes. The model correctly classified 75.6% of cases, an increase of 7.10% from the null model.

Influence of Demographic Factors Education level did not significantly predict making a lifestyle change, p = .823. Sex did not significantly predict making a lifestyle change, p = .201. However, age did significantly predict making a lifestyle change, b = .029, p < .001. For each year older a participant was, they were 1.02 times more likely to make a lifestyle change to reduce the risk of dementia.

Influence of Concern and Exposure One’s exposure to family or friends with dementia did not significantly predict making a lifestyle change, p = .102. Level of concern about caring for a family member with dementia was negatively related to making a lifestyle change, b = -1.124, p = .002. Those who reported being ‘not at all concerned’ were 66% more likely to make a lifestyle change to reduce their risk of dementia as compared to those who were ‘very concerned’.

Influence of Dementia Knowledge Tacit (Practical) Tacit knowledge significantly predicted making a lifestyle change, b = .39, p = .027. Those with greater tacit knowledge of dementia were 1.48 times more likely to make a lifestyle change. Explicit (Factual) Explicit knowledge significantly predicted making a lifestyle change, b = .112, p = .002. Those with greater explicit knowledge of dementia were 1.12 times more likely to make a lifestyle change.

Implications The finding that those older in age are more likely to make a lifestyle change may be concerning. Lifestyle changes made earlier in life may be more effective in reducing dementia risk. There should be a greater focus on making these changes earlier in life to make these changes as effective as possible. Both practical and factual knowledge are important for the decision to make lifestyle changes to reduce the risk of dementia. Dementia friendly (inclusive) communities are a first step in helping to increase the public’s knowledge of dementia, specifically tacit knowledge that may be gained by interacting with persons with dementia.

Limitations and Future Directions The current study was cross-sectional in nature. A longitudinal study would provide more information about the importance of these variables as one ages. Future research should manipulate exposure to programs aimed at increasing one’s tacit and explicit knowledge regarding dementia. Results of these studies can inform community programs and policy changes geared towards the reduction of dementia risk. This is necessary as the world population continues to age.

Questions?