Neighborhood Social Cohesion and Dementia-Related Stigma Among Mothers of Adolescents in the Pre- and Current COVID-19 Period: An Observational Study Using Population-Based Cohort Data

Abstract

Background: Middle-aged adults may be the ideal target group for dementia-related stigma reduction interventions to encourage the utilization of services among those who may become family caregivers. Neighborhood social cohesion may diminish dementia-related stigma, particularly in terms of perceived public attitudes. The COVID-19 pandemic can further negatively impact perceived public stigma. Objective: To investigate the association between neighborhood social cohesion and dementia-related stigma during the pre- and current COVID-19 period. Methods: We employed a cross-sectional design using data from a large population-based cohort, the Tokyo Teen Cohort, in Japan. Overall, 2,469 mothers of 16-year-old adolescents self-completed a questionnaire comprising nine dementia-related stigma questions evaluating perceived public and personal attitudes. Neighborhood social cohesion was assessed using a five-item instrument. The participants were divided into two groups according to the time of assessment: prior to the pandemic’s onset (February 2019–March 2020) and during the pandemic (April 2020–July 2021). A multiple regression analysis of stigma was performed using neighborhood social cohesion as an independent variable, and caring experience, age, educational level, and working status as covariates. Results: Personal and perceived public stigma were significantly lower in participants who perceived greater neighborhood social cohesion. However, level of personal and perceived public stigma did not differ between pre- and during the pandemic period. Conclusion: Neighborhood social cohesion may be a modifiable factor for dementia-related stigma. A localized intervention to enhance social cohesion in the neighborhood community would promote the utilization of services among those who may become family caregivers.

Understanding stigma of dementia during COVID-19: a scoping review

“…Consequently, a lack of trust was related to the information spread by institutions such as the media and the government ( 21 ). For example, systemic discrimination and messaging from the government organizations, traditional news media ( 21 , 25 ), and online social media ( 27 ) were reported to heighten the intersection of dementia-related stigma and issues of racism.…”

“…Structural stigma was evident in the theme of cultural inequities and distrust among ethnic and racial minority groups of people living with dementia. For example, our review identified barriers related to systemic racism, discrimination, denied healthcare services, and inadequate culturally sensitive care ( 21 , 25 , 27 ). This finding is consistent with pre-pandemic research that indicates that structural stigma in the form of systemic racism and structural discrimination are entrenched in history and has been negatively impacting people with dementia from ethnic and racial minority groups ( 39 , 40 ).…”

Socioeconomic inequality and contributors in accepting attitudes toward people living with HIV among adults in Ethiopia from 2005 to 2016: a population-based cross-sectional study

“…Wealth inequality loosens social cohesion 37. People with a higher wealth status had better social cohesion,38 which reduced stigma (maximise attitude) among people with chronic diseases 39. Thus, the higher the SES, the more social cohesiveness leads to better HIV service utilisation,40 which can improve attitude toward people living with HIV.…”

“… 37 People with a higher wealth status had better social cohesion, 38 which reduced stigma (maximise attitude) among people with chronic diseases. 39 Thus, the higher the SES, the more social cohesiveness leads to better HIV service utilisation, 40 which can improve attitude toward people living with HIV. Socioeconomic-related inequality was higher between women and men, but women had better comprehensive knowledge persistently.…”

Strategies for fostering residents' positive attitude toward social participation of people with dementia: A cross‐sectional analysis

“…These questions were selected to assess respondents' general attitudes toward PWD's social participation and explore their willingness to accommodate PWD. Explanatory variables were selected from past studies on stigma toward dementia, 5,7 and included experience with PWD, education on dementia, frequency of social contact with others, and trust for people in the community. Sex-stratified age groups, education, marital status, and other factors were also assessed (Supplementary File 1).…”