A better insight into older adults’ understanding of and attitude towards cognitive disorders and their prevention, as well as expectations and reasons for participation in prevention trials, would help design, conduct, and implement effective preventive interventions. This qualitative study aimed at exploring the knowledge and perceptions of cognitive disorders and their prevention among participants in a prevention trial. Semi-structured interviews were conducted among the participants of a multinational randomised controlled trial testing the efficacy of a lifestyle-based eHealth intervention in preventing cardiovascular disease or cognitive decline in community dwellers aged 65+. Participants were probed on their reasons for participation in the trial and their views on general health, cardiovascular disease, ageing, and prevention. The subset of data focusing on cognitive disorders (15 interviewees; all in Finland) was considered for this study. Data were analysed using content analysis. Participants’ knowledge of the cause and risk factors of cognitive disorders and prevention was limited and superficial, and a need for up-to-date, reliable, and practical information and advice was expressed. Cognitive disorders evoked fear and concern, and feelings of hopelessness and misery were frequently expressed, indicating a stigma. Strong heredity of cognitive disorders was a commonly held belief, and opinions on the possibility of prevention were doubtful, particularly in relation to primary prevention. Family history and/or indirect experiences of cognitive disorders was a recurrent theme and it showed to be linked to both the knowledge of and feelings associated with cognitive disorders, as well as attitude towards prevention. Indirect experiences were linked to increased awareness and knowledge, but also uncertainty about risk factors and possibility of prevention. Distinct fear and concerns, particularly over one’s own cognition/risk, and high motivation towards engaging in prevention and participating in a prevention trial were also identified in connection to this theme. Family history and/or indirect experiences of cognitive disorders were linked to sensitivity and receptiveness to brain health and prevention potential. Our findings may be helpful in addressing older adults’ expectations in future prevention trials to improve recruitment, maximise adherence, and facilitate the successful implementation of interventions.

中文翻译：

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痴呆症的经历和对预防的态度：参与预防试验的老年人的定性研究


更好地了解老年人对认知障碍及其预防的理解和态度，以及参与预防试验的期望和原因，将有助于设计、实施和实施有效的预防干预措施。这项定性研究旨在探讨预防试验参与者对认知障碍及其预防的知识和看法。对一项跨国随机对照试验的参与者进行了半结构化访谈，该试验测试了基于生活方式的电子健康干预措施在预防 65 岁以上社区居民心血管疾病或认知能力下降方面的功效。调查了参与者参与试验的原因以及他们对一般健康、心血管疾病、衰老和预防的看法。本研究考虑了关注认知障碍的数据子集（15 名受访者；全部来自芬兰）。使用内容分析对数据进行分析。参与者对认知障碍的原因和危险因素以及预防的了解有限且肤浅，并表示需要最新、可靠和实用的信息和建议。认知障碍会引起恐惧和担忧，人们经常表达出绝望和痛苦的感觉，这表明了一种耻辱。人们普遍认为认知障碍具有很强的遗传性，并且对预防的可能性持怀疑态度，特别是在一级预防方面。认知障碍的家族史和/或间接经历是一个反复出现的主题，它与认知障碍的知识和感受以及对预防的态度有关。 间接经验与认识和知识的提高有关，但也与风险因素和预防可能性的不确定性有关。还发现与该主题相关的明显恐惧和担忧，特别是对自己的认知/风险的恐惧和担忧，以及参与预防和参与预防试验的高度动机。认知障碍的家族史和/或间接经历与大脑健康和预防潜力的敏感性和接受性有关。我们的研究结果可能有助于满足老年人在未来预防试验中的期望，以改善招募、最大限度地提高依从性并促进干预措施的成功实施。