Peer group leadership for dementia health risk reduction

Abstract

AbstractBackgroundWith the worldwide number of persons with dementia predicted to triple by 2050 and a current lack of curative treatment [1], reduction of modifiable risks is increasingly important. In 2020 the Lancet Commission on Dementia, Prevention, and Care reported on twelve health risk management factors that could potentially reduce the risk of dementia [2]. Peer support groups have a history in supporting self‐management of health risk behaviour [3,4]. We wanted to learn if older adults have successfully provided peer leadership in group interventions for older adult health management.MethodUsing the Joanna Briggs Institute methodology for scoping reviews we searched three databases (Medline, Embase, and AgeLine) for articles describing older adult leadership for older adult health improvement in older adult health promotion or improvement groups. From the initial 16,000+ results, 19 studies met the criteria for full text screening and analysis.ResultOf the 19 studies, 12 used peer leaders and seven had a reciprocal support model. For those using peer leaders, training varied from none to 30 weeks. Older adult leadership or reciprocal support occurred in a range of settings. There were studies examining an older adult run seniors centre and a supportive community engagement program. Six studies focused on diabetes or hypertension, conditions linked with dementia risks. Interventions lasted from four weeks to 24 years. No quantifiable patterns of health management were observed. The only pattern that emerges is that positive physical and behaviour changes occurred more often when peer leaders or co‐facilitators were expected to motivate or encourage participant engagement or mutual support and where expectations included participant goal setting behaviour. Most of the studies of 12 weeks or less did not see lasting changes.ConclusionsWhen asked participants preferred and appreciated peer leadership; however, peer leadership itself was not sufficient for positive health changes. Research with a sharing and empowerment focus within groups often led to improved self‐efficacy and self‐management behaviours. Research with longer participant engagement may result in longer lasting health habits.