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The association between health beliefs and attitudes towards dementia and the intention to change health behavior for dementia risk reduction: A cross‐sectional study in the Netherlands
Author(s) -
Matulesseij Tessa,
Joxhorst Tessa,
Vrijsen Joyce,
Smidt Nynke
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.042139
Subject(s) - dementia , transtheoretical model , mediterranean diet , medicine , confounding , gerontology , logistic regression , cross sectional study , behavior change , psychology , environmental health , intervention (counseling) , disease , psychiatry , pathology
Background Approximately one third of the dementia cases are attributed to modifiable risk factors, including physical inactivity, unhealthy diet, excessive alcohol use and smoking (Livingston et al., 2017). Positive health beliefs and attitudes towards dementia (risk reduction) may encourage adopting a healthy lifestyle. We aimed to investigate the association between health beliefs and attitudes towards dementia and the intention‐to‐change health behavior for dementia‐risk‐reduction among the Dutch general population. Method A random sample of 4500 residents of the municipality of Groningen (The Netherlands), aged 30 to 80 years, was invited to complete an online survey. Health beliefs and attitudes were measured using the cross‐cultural validated Dutch Motivation to Change Lifestyle and Health Behavior for Dementia‐Risk‐Reduction scale (perceived susceptibility, perceived severity, perceived benefits and barriers, cues to action, general health motivation, self‐efficacy). The intention‐to‐change health behavior (physical activity, diet, alcohol consumption, and smoking) was measured using the stages‐of‐change (contemplation and preparation stage versus pre‐contemplation, action or maintenance stage). We used multiple logistic regression analyses adjusting for potential confounders (age, sex, education, employment). Results 655 residents participated in the survey (mean(SD) age: 58(13.4) years, 54% female). Sixty percent were physically inactive, 44% were excessive‐alcohol‐users, 13% were smokers and all participants (100%) had a poor‐to‐moderate adherence to the Mediterranean‐DASH‐Intervention‐for‐Neurodegenerative‐Delay (MIND)‐diet. Older participants had higher scores on perceived severity and lower scores on perceived benefits, perceived barriers and self‐efficacy. Participants with a higher education level had higher scores on perceived benefits and self‐efficacy, but lower scores on perceived barriers. Overall, positive attitudes and health beliefs towards dementia‐risk‐reduction are associated with the intention‐to‐change physical activity (OR=1.058; 95%‐CI:1.031,1.087), diet (OR=1.049; 95%‐CI:1.024,1.073) and alcohol use (OR= 1.045; 95%CI:1.006,1.086). Conclusion Attitudes and health beliefs towards (dementia) risk reduction in the Netherlands are poor. People with positive health beliefs and attitudes towards (dementia) risk reduction have more often the intention‐to‐change their health behaviors. Dementia prevention should focus on education of the general population to improve their knowledge about dementia in general and the risk and protective factors for dementia. Further research should investigate the effectiveness of improving health beliefs and attitudes towards (dementia) risk reduction on health behavior change.