Self-perceived risk of dementia associated with mental health, race or ethnicity

Survey data published in JAMA Neurology indicate that about half of American adults perceive themselves as at least somewhat susceptible to developing dementia. Despite this, few respondents indicated that they had consulted a doctor about preventing dementia.

Investigators administered a survey of participants in the 2018 University of Michigan National Survey on Healthy Aging (NPHA) survey. The NHPA is a representative national survey of non-institutionalized civilian adults aged 50 to 80; however, the researchers only interviewed ANSP participants aged 50 to 64. The survey collected demographic information, self-reported health status and the perceived probability of developing dementia. The probability of dementia was determined using a multiple choice question with 3 possible answers: “very likely”, “somewhat likely” and “not likely”. Participation in memory preservation activities was also assessed. Logistic regression analyzes were performed to identify the correlations between the risk of self-rated dementia and the characteristics of respondents, including age, sex, race / ethnicity, education, household income, physical and mental health.

Among 1,018 respondents, 44.3% (95% CI, 41.1-47.5) said they were at least “somewhat” likely to develop dementia. In addition, 4.2% (95% CI, 3.1-5.8) said they were “very likely” to develop dementia. In the adjusted analyzes, non-Hispanic black respondents were much less likely than non-Hispanic white respondents to believe that they could develop dementia (adjusted odds ratio [AOR]0.51; 95% CI, 0.32-0.81; P = 0.01). Respondents who rated their mental health as “fair” or “poor” reported a higher probability of developing dementia (AOR, 2.30; 95% CI, 1.19-4.47; P = 0.01) compared to those who reported “excellent” or “very good” mental health. However, the risk of self-rated dementia was not significantly higher in respondents with fair or poor physical health compared to those with excellent or very good physical health (OR, 1.46; 95% CI, 0, 93 to 2.28; P = .10). Only 5.2% (95% CI, 4.0-6.8) of respondents said they had discussed dementia prevention with their provider. Discussions with a doctor about dementia were more frequent among respondents with a higher perceived probability of dementia risk than among those with a lower perceived probability (7.1% [95% CI, 5.1-9.8] vs 3.6% [95% CI, 2.2-5.7]; P = 0.02). Despite low rates of discussion with a doctor, 31.6% of respondents (95% CI, 28.7-34.6) reported using fish oil or ω-3 fatty acids, and 39, 2% (95% CI, 36.1-42.4) reported using other vitamins or supplements.

According to these data, a significant proportion of older American adults think they are at least somewhat likely to develop dementia. In particular, non-Hispanic blacks reported a lower self-assessed risk, despite a higher prevalence of dementia than any other racial or ethnic group. “Mature adults may not accurately estimate their risk of developing dementia, which could lead to overuse and underuse if preclinical dementia treatments become available,” the investigators wrote. Appropriate use of evidence-based approaches is necessary to adequately manage the risk of dementia in older adults.

Reference

Maust DT, Solway E, Langa KM, et al. Perception of the risk of dementia and preventive actions in American adults aged 50 to 64 [published online November 15, 2019]. JAMA Neurol. doi: 10.1001 / jamaneurol.2019.3946

This article originally appeared on Medical Bag

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