Dementia risk perception vis-a-vis actual action among Americans

By Dr. Ananya Mandal, MDNov 17 2019

A study has shown that one in two Americans between age 50 and 64 years is aware of the risk of development of dementia with age but only 5 percent are actually visiting their healthcare providers to seek preventive and therapeutic attention. The study results titled, “Perception of Dementia Risk and Preventive Actions Among US Adults Aged 50 to 64 Years,” was published as a research letter to the Editor in the latest issue of the JAMA Neurology. The team of researchers also presented the highlights of the study the Gerontological Society of America's annual meeting. The study comes from a team of researchers from the University of Michigan's Institute for Healthcare Policy and Innovation.

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The new study reveals that nearly 50 percent of the older Americans are aware of the risks associated with dementia. This has been an improvement from the earlier evidence say the researchers. However, only one third of these individuals are taking active steps to prevent dementia with age. These steps include doing brain work such as crossword and other puzzles, taking necessary supplements etc. Only 5 percent of this population of Americans actually seek help from their healthcare providers for necessary guidance on preventing and treating dementia and early stages of dementia respectively, write the researchers.

This study reveals the need for counselling of the middle aged Americans on the need of seeking help when needed as well as the steps they can adopt in their lifestyles to prevent and delay the onset of dementia. The researchers warn that prevention is the key to dementia because with the market being flooded by various medications against the condition, there may be unnecessary and over use of these drugs.

For this study the team of researchers included 1019 individuals across the nation aged between 50 and 64 years. The data on the patients was collected from the National Poll on Healthy Aging, which was carried out by the IHPI and was supported by the AARP and Michigan Medicine (academic medical centre of University of Michigan).

The respondents of the study were asked questions, “‘How likely are you to develop dementia during your lifetime?’ (with the possible answers being “very likely,” “somewhat likely,” and “not likely”); “Have you ever discussed ways to prevent dementia with your doctor?”; and about 4 specific strategies to “maintain or improve your memory” (with the possible answers being yes or no). The outcome of interest was perceived likelihood of developing dementia (very/somewhat likely vs not likely).”
Results revealed that 32 percent of the population being aware of the benefits of certain supplements took fish oil supplements that contain omega-3 fatty acids. Another 39 percent took other supplements to improve their brain health. One in two individuals were regular with brain games, puzzles, crossword etc. to keep their brains active and sharp.

Lead author Donovan Maust, a geriatric psychiatrist who specializes in dementia-related care, said that the risk of dementia is less than one in three among individuals over the age of 85 years. The risk rises after the age of around 65 years he added. Some ethnic and racial groups such as Latino or African-American individuals are more at risk of dementia he explained.

The team warned that people should start taking steps to keep their brains active in their fifties and early sixties. This would effectively delay or even prevent the onset of dementia. Maust said, “There is growing evidence that adults in mid-life can take steps to lower their risk of dementia, including increasing physical activity and controlling health conditions like hypertension and diabetes. Unfortunately, our findings suggest that people may not be aware of this and are not asking their doctor.”

Erica Solway, Ph.D., M.S.W., the co-director of the national poll says that the risk may not be as much as perceived by most people. However the risk of dementia is 50 percent greater among those of Latino descent. African-Americans too carry double the risk of dementia compared to whites with no latino background. The team also noted that persons who had physical problems such as high blood pressure, diabetes and other heart problems are more likely to suffer from dementia compared to those who are otherwise healthy physically. Maust said public awareness regarding prevention of dementia during fifties and early sixties could focus on improving physical health by raising physical activity, quitting smoking, reducing alcohol and calorie intake and tight control of blood glucose and blood pressure. This is the responsibility of the public health bodies as well as physicians says Maust.

Authors of the study thus wrote in conclusion, “Given repeated failures of disease-preventing or disease modifying treatments for dementia, interest in treatment and prevention have shifted earlier in the disease process. Adults in middle age may not accurately estimate their risk of developing dementia, which could lead to both overuse and underuse if preclinical dementia treatments become available. Policy and physicians should emphasize current evidence-based strategies of managing lifestyle and chronic medical conditions to reduce the risk of dementia.”