Survey data published in JAMA Neurology indicate that approximately half of US adults perceive themselves to be at least somewhat likely to develop dementia. Even so, few respondents indicated that they had seen a physician about dementia prevention.

Investigators administered a survey to participants in the 2018 University of Michigan National Poll on Healthy Aging (NPHA). The NHPA is a nationally representative poll of civilian, noninstitutionalized adults aged 50 to 80 years; however, researchers only queried NPHA participants aged 50 to 64 years. The survey captured demographic information, self-reported health status, and self-perceived likelihood of developing dementia. Likelihood of dementia was determined using a multiple-choice question with 3 possible answers: “very likely,” “somewhat likely,” and “not likely.” Participation in memory-preserving activities was also assessed. Logistic regression analyses were performed to identify correlations between self-perceived dementia risk and respondent characteristics including age, sex, race/ethnicity, education, household income, physical health status, and mental health status.

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Among 1018 respondents, 44.3% (95% CI, 41.1-47.5) reported that they were at least “somewhat” likely to develop dementia. An additional 4.2% (95% CI, 3.1-5.8) reported that they were “very likely” to develop dementia. In adjusted analyses, non-Hispanic black respondents were significantly less likely than non-Hispanic white respondents to believe that they may develop dementia (adjusted odds ratio [AOR], 0.51; 95% CI, 0.32-0.81; P =.01). Respondents who rated their mental health as “fair” or “poor” reported a higher likelihood of developing dementia (AOR, 2.30; 95% CI, 1.19-4.47; P =.01) compared with those who reported “excellent” or “very good” mental health. However, self-perceived dementia risk was not significantly higher among respondents with fair or poor physical health compared with those with excellent or very good physical heath (OR, 1.46; 95% CI, 0.93-2.28; P =.10). Only 5.2% (95% CI, 4.0-6.8) of respondents reported discussing dementia prevention with their provider. Discussing dementia with a physician was more common among respondents with a higher perceived likelihood of dementia risk, compared with those with a lower perceived likelihood (7.1% [95% CI, 5.1-9.8] vs 3.6% [95% CI, 2.2-5.7]; P =.02). Despite low rates of discussion with a physician, 31.6% of respondents (95% CI, 28.7-34.6) reported using fish oil or ω-3 fatty acids, and 39.2% (95% CI, 36.1-42.4) reported using other vitamins or supplements.

Per these data, a significant proportion of older US adults believe they are at least somewhat likely to develop dementia. Notably, non-Hispanic black individuals reported lower self-perceived risk, despite having a higher prevalence of dementia than any other racial or ethnic group. “Adults in middle age may not accurately estimate their risk of developing dementia, which could lead to both overuse and underuse if preclinical dementia treatments become available,” investigators wrote. Judicious use of evidence-based approaches is necessary to appropriately manage dementia risk in older adults.

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Maust DT, Solway E, Langa KM, et al. Perception of dementia risk and preventive actions among US adults aged 50 to 64 Years [published online November 15, 2019]. JAMA Neurol. doi:10.1001/jamaneurol.2019.3946