Towards specialized dementia risk reduction services for those with first cognitive symptoms: A mixed-method study into risk awareness, needs, and preferences among individuals with subjective cognitive decline and mild cognitive impairment from memory clinic and community settings and memory clinic professionals

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Abstract
Background: Individuals with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are at increased risk of dementia and may benefit from lifestyle-based strategies for secondary prevention in clinical practice. Objective: To examine risk awareness, needs and preferences for dementia risk reduction in individuals with self-reported SCD and MCI and memory clinic professionals. Methods: Using a mixed-methods approach, we conducted online surveys to examine risk awareness, needs and preferences, and semi-structured interviews to explore barriers and facilitators related to online dementia risk reduction. Results: 1167 individuals with SCD (n = 1092) and MCI (n = 75), predominantly community-based research volunteers and a smaller group recruited via memory clinics, and 58 professionals completed the survey. Among SCD/MCI individuals, 39.5% were unaware that dementia risk can be reduced through lifestyle changes, 97.5% were interested in obtaining such information, and 97.9% considered using an online dementia risk management tool. Among professionals, 10.3% were unaware of dementia risk reduction, and 87.0% considered using a tool on this topic during consultations. Cardiovascular risk factors were poorly recognized by SCD/MCI individuals and, though acknowledged by professionals, rarely discussed in consultations. Interviews with SCD/MCI individuals (n = 14) and professionals (n = 9) highlighted several areas supporting implementation of an online dementia risk management tool (e.g., personalization, up-to-date information, coaching). Conclusions: Dementia risk awareness was low among SCD/MCI individuals, and high among memory clinic professionals. Both groups showed strong interest in using an online dementia risk management tool, and specific content, design and delivery features may influence engagement. Findings should be interpreted recognizing the mostly online-recruited, higher-educated study sample.
Funding Information
  • ZonMw (#73305095007)
  • Health~Holland (PPS allowance; #LSHM20106)
  • GIESKES-STRIJBIS FONDS

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