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A dementia risk assessment tool to facilitate risk‐related behaviour change: The dementia risk profile
Author(s) -
Farrow Maree,
Kim Sarang,
Bindoff Aidan,
Doherty Kathleen,
Eccleston Claire,
Vickers James C
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.046604
Subject(s) - dementia , risk assessment , cognitive decline , risk factor , gerontology , psychological intervention , medicine , disease , cognition , risk analysis (engineering) , psychology , environmental health , clinical psychology , psychiatry , computer science , computer security , pathology
Background Several risk assessment tools have been developed to estimate an individual’s risk of developing dementia. These measure age, self‐report measures of risk‐related activity and health conditions, and/or physiological measures of vascular or genetic risk. An understanding of actions that one can undertake is required to facilitate individual risk reduction. We developed the Dementia Risk Profile (DRP), focusing on assessment of risk‐related behaviour rather than actual risk, with the aim of providing information to individuals to enable risk reduction. Method The WHO Guidelines for Risk Reduction of Cognitive Decline and Dementia recommend interventions for eight modifiable risk factors. For each of these we identified the behaviours associated with mitigating risk. We adapted relevant sections of the short form Australian National University Alzheimer’s Disease Risk Index to develop questions for the DRP and included questions to assess adherence to the Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND) diet. Item development focused on ease of understanding and responding, provision of feedback on actions that could be taken to reduce risk, and tracking behaviour change over time. Result The final DRP survey measures: diagnosis, regular checks and management for blood pressure, cholesterol and diabetes; body mass index; MIND diet adherence; frequency of engagement in cognitive activities; time spent engaging in walking, moderate and vigorous physical activity; frequency and amount of alcohol consumption and smoking tobacco. Algorithms calculate an individual’s risk state for each factor and a traffic light system informs the individual of their status (e.g. red = high risk). Change within a state (e.g. still smoking but smoking less) can also be indicated, to motivate ongoing risk‐reducing behaviour change. Written feedback for each factor is provided under the headings ‘What the science says’, ‘Your status’ and ‘What can you do?’ The DRP has been implemented in a randomised controlled trial (n=414) and a population‐level public health intervention (n=3269). Conclusion Initial DRP data and user feedback will inform development to ensure its capacity to inform individuals about their risk and facilitate behaviour change that has a positive impact on their dementia risk in addition to their overall health.