Modifiable dementia risk factors are associated with greater subjective cognitive concerns but not perceived susceptibility to dementia in late middle‐aged adults: Baseline characteristics of the BetterBrains Trial

Abstract

AbstractBackgroundA range of lifestyle factors in midlife can increase risk for developing dementia in late‐life.1 However, it remains unclear whether the presence of such risk factors (RFs) is associated with individuals’ insight into their risk of developing dementia. In a group of middle‐aged adults with a family history of dementia enrolled in a lifestyle prevention trial, we measured associations between modifiable RF prevalence, subjective cognitive concerns, and perceived susceptibility to dementia.MethodParticipants (n = 456) enrolled in BetterBrains (betterbrains.org.au)2 completed a comprehensive self‐report RF assessment at baseline. Modifiable dementia risk was determined across four domains (vascular health, social/cognitive engagement, mood, sleep) and trial eligibility required risk in at least one domain. Participants were grouped according to the number of domains in which they reported high‐risk (ranging from 1‐4). Participants completed the Cognitive Function Instrument, and a brief questionnaire to assess perceived susceptibility to dementia (Motivation to Change Lifestyle/Health Behaviours for Dementia Risk Reduction scale). Linear regressions examined associations between modifiable RF prevalence, subjective cognition, and perceived susceptibility to dementia, adjusting for age, sex, education, negative beliefs about ageing, and beliefs about protective health behaviours on dementia risk.ResultParticipants were mostly female (80%), with an average age of 59.4 years and 15.2 years of education. Of the sample, 29.6% reported risk in all domains (29.6%) and 16.9% in three domains. Risk in a higher number of RF domains was significantly associated with greater subjective cognitive concerns (β(SE) = 0.18(0.06), p = <.001), but not with greater perceived susceptibility to developing dementia (β(SE) = 0.62(0.35), p = .08). Increasingly negative beliefs about ageing and weaker beliefs in the protective effect of health behaviours were the only significant predictors of perceived susceptibility to dementia (both p’s <.05).ConclusionIn middle‐aged adults, dementia RFs are associated with greater subjective cognitive concerns, but not with an increased perception of susceptibility to dementia. Incongruence between participants’ self‐report of subjective cognitive concerns and susceptibility to dementia may be due in part to poor knowledge on modifiable dementia RFs.3 Perceptions of personal susceptibility to dementia may also be tied more closely to negative ageing stereotypes typically associated with older age and family history of disease.