Social disadvantage outweighs knowledge in dementia risk

Public health efforts promote dementia knowledge to reduce risk, but it is unclear whether knowledge predicts lower risk compared to social determinants like education and socioeconomic status (SES).

We analyzed cross-sectional data from 1730 adults to examine how age, sex, education, SES, family history of dementia, and Alzheimer's disease (AD) knowledge predicted behavioral and health-related dementia risk. We used linear regressions and machine learning to compare the explanatory and predictive value of each factor.

Lower SES and education were the strongest predictors of increased behavioral risk. Health-related risk was associated only with SES. AD knowledge accuracy and confidence were not significantly associated with either index. Machine learning confirmed these patterns, with SES and education emerging as key features.

Low SES and education were more strongly linked to dementia risk than AD knowledge. Findings underscore the need for equity-focused strategies beyond public awareness campaigns to improve knowledge.