Dementia risk literacy in older Australians: beyond knowledge

Knowledge about dementia risk influences preventive behaviours, yet has been primarily explored as risk factor awareness. This study investigated the understanding of dementia prevention by systematically assessing general dementia risk knowledge and participants' capacity to recognise specific evidence-based dementia risk mitigation strategies and identify common misconceptions about purported mitigation strategies.

This cross-sectional study used the Knowledge of Dementia Risk Reduction survey instrument to assess dementia literacy. The multi-component instrument assesses general knowledge about dementia risk, recognition of mitigation strategies for risk factors and the ability to appraise specific common misconceptions. Items were generated from a literature review and expert consultation. The instrument was administered to participants of an Australian online public health cohort study into dementia risk self-management.

Participants numbered 3334 and had a median age of 62 years. Most (72.5%) identified as female; 44.5% had a university education, and 49.1% had a family history of dementia. Most participants (79.5%) agreed that you can reduce your chances of developing dementia. The most recognised mitigation strategies included increased physical activity, social activity and cognitive stimulation, with one-quarter of participants unsure about the management of cholesterol and adoption of a Mediterranean diet. Scores for general dementia risk knowledge and recognition of modifiable risk reduction were midrange and moderately correlated with each other. Correct appraisal of common misconceptions; for example, that aluminium exposure is a risk factor, was poor; only 5.0% of participants scored a midrange score (6/12) or higher, and only 0.2% of participants correctly identified all misconception items.

The study highlights the additional insights offered by simultaneously assessing multiple components of dementia risk literacy. Participants in the study demonstrated some knowledge of dementia risk and risk factor mitigation strategies, but had a poor appraisal of common misconceptions. Such insights can inform risk reduction messaging and enable more effective public health campaigns for future risk mitigation.