To change or not to change? Determinants of changing lifestyle and health behaviour for dementia risk reduction

Abstract

Behavioural and lifestyle changes are something we all try to achieve at least once in our lives. However, not everyone successfully carries out or maintains the changes we intend to make. Health behavioural and lifestyle changes for dementia risk reduction may appear to be harder to make as the changes have to be made early in our lives (most effectively in mid-life or earlier) and the changes need to be maintained for a longer period of time (until late-life). In addition, the changes need to be multi-domain as one specific lifestyle and health behaviour change may not be effective in dementia risk reduction. Health behaviour and lifestyle factors that reduce the risk of, and increase the protection from developing dementia have been identified. However, motivations for changing lifestyle and health behaviours, as well as whether the actual health behaviour and lifestyle changes are made have yet to be identified. This thesis explores the determinants of behavioural and lifestyle changes for dementia risk reduction. The broad substantive aims of this thesis are: 1) to better understand potential consumers of dementia risk reduction interventions, 2) to develop a scale assessing beliefs and attitudes about lifestyle and health behavioural changes for dementia risk reduction, 3) to identify predictors of intentions to change lifestyle and health behaviour for dementia risk reduction, 4) to examine attitudes towards dementia compared to other common chronic diseases, and 5) to identify the determinants of health behavioural and lifestyle changes for dementia risk reduction. Five sub-studies have been conducted to achieve the aims of this thesis. The first study, a focus group study, investigates motivators and barriers for intentions to change lifestyle and health behaviours for dementia risk reduction. This study also examines potential consumers' knowledge of, and perception towards dementia. The second study involves the development of a scale based on the Health Belief Model. The third study tests the applicability of this scale on intentions to change lifestyle and health behaviours. The fourth study conducts a cross-national investigation examining people's attitude towards dementia and their willingness to make lifestyle and health behavioural changes for dementia compared to other chronic diseases. Finally, the fifth study assesses determinants of intentions as well as actual health behavioural and lifestyle changes for dementia risk reduction among individuals with increased risk. This thesis is the first of its kind attempting to use a theoretically driven scale to understand potential intervention users' beliefs and attitudes about health behaviour and lifestyle changes for dementia risk reduction. The findings suggest that the determinants for behavioural and lifestyle changes were different from determinants for intentions to change lifestyle and health behaviour for dementia risk reduction. People with high intentions do not necessarily change their health behaviour and lifestyle for dementia risk reduction as well. It was also suggested that the motivations/predictors of behaviour and lifestyle changes for dementia risk reduction differ between males and females. Therefore, it would be cost effective and more accurate to take gender differences into consideration when designing interventions in dementia prevention. Show more