The public’s perspectives on lifestyle-related behavior change for dementia risk reduction: a qualitative study

Abstract

Background: There is accumulating evidence that addressing modifiable risk and protective factors has an impact on dementia rates. Insight into the public’s perspectives on dementia risk reduction is needed to inform future individual-level interventions and public health approaches.Objective: This study explores the publics’ openness towards dementia risk reduction and willingness towards changing lifestyle behavior to reduce the future risk for dementia.Methods: Using a screening questionnaire, participants were purposively selected based on lifestyle behaviors that are associated with dementia risk. One-on-one interviews were used to explore their openness towards dementia risk reduction and willingness towards behavior change. Independently, two researchers performed an inductive content analysis.Results: Interviews were conducted with 23 participants aged from 40 to 79 years. Main themes that were identified from the data were: (a) abstractness of dementia risk reduction, (b) ambivalence towards changing behavior, (c) negative self-image and low behavioral control, and (d) all-or-nothing thinkingabout lifestyle change.Conclusion: The concept of dementia risk reduction seems difficult to translate to the personal context, particularly if individuals perceive that dementia would occur decades in the future. This is problematic because a large proportion of the public needs a healthier lifestyle to reduce the incidence of dementia. Translating healthy intentions into behavior is complex and involves overcoming a variety of barriers that complicate dementia risk reduction initiatives. Support is needed for individuals who experience additional obstacles that obstruct commencing to a healthier lifestyle (e.g., negative self-image, engaging in multiple unhealthy behaviors, unrealistic perceptions about lifestyle change).

Socio-cognitive determinants of lifestyle behavior in the context of dementia risk reduction: a population-based study in the Netherlands

“…Formulating coping responses to overcome specific barriers and cope with difficult situations may further facilitate goal achievement [51]. In earlier qualitative research [11], we observed that low perceived control frequently resulted from earlier failed attempts to change lifestyle behavior. This underscores the importance of providing support to individuals who experience relapse, for example by encouraging them to view it as a part of the behavior change process and use it as an opportunity to learn from the experience [52].…”

“…In this cross-sectional study, we used a screening questionnaire to identify individuals with room to improve their lifestyle behavior and we invited them for a follow-up questionnaire to explore sociocognitive determinants of these behaviors. The study protocol was pre-registered [17] and materials and data to replicate the findings are open access available [18]. The findings are reported using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist [19].…”

“…Questionnaires were developed through in triangulation with literature, an interview study (n=23) [11], and think-aloud sessions with experts in dementia risk reduction (n=4). The questionnaires were pre-tested with three middle-aged and older individuals of low socio-economic status (SES) who participate in an advisory board consulting on research.…”

“…Definitions and measurement instructions for behavioral determinant research informed the item development [26]. Insights from a prior interview study [11] led to the development of items targeting behavior-specific determinants. For exemple, interviewees frequently mentioned they did not enjoy cooking, which resulted in an item to assess attitudes towards cooking.…”

“…For example, the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction Scale (MCLHB-DRR) offers understanding of determinants of generic lifestyle change [10], without delving into determinants of specific behaviors, such as attitudes about diet or self-efficacy towards smoking cessation [10]. This represents a limitation, as individuals are often more positive towards broader lifestyle change than to altering particular unhealthy behaviors [11]. Furthermore, it is well-known that determinants are highly behavior specific, which makes it impossible to intuitively select relevant determinants, even for experts in behavior change [12].…”