Public Health

Alzheimers Dement. 2024 Dec;20 Suppl 7:e090823. doi: 10.1002/alz.090823.

ABSTRACT

BACKGROUND: Alzheimer's disease (AD) is highly feared. Fear can prevent individuals from seeking help. By age 65, women's risk of developing AD is 1 in 5. Women also make up the majority of dementia carers. Therefore, older women may be particularly vulnerable to dementia-related fear and its negative impacts. Across two studies, we examined (1) associations between dementia-related fear and psychosocial functioning and (2) the effectiveness of a brief intervention to reduce fear in older women with and without a dementia family history.

METHOD: Participants were women aged >55 years without a dementia diagnosis. In study 1, participants completed measures of dementia-related fear and memory failures. In study 2, participants were randomized into intervention (psychoeducation, mindful grounding, exposure/behavioral activation) or control groups (psychoeducation, mindful grounding), and completed measures of dementia-related fear, memory failures, depression, social function, and well-being.

RESULT: Study 1 included 285 women (66.1±7.1 years; Fx = 45.6%). Dementia-related fear was positively associated with memory failures (r = .64, p<.001); fear was elevated in women with a dementia family history (p = .002, η² = .03; Fig. 1A). Study 2 included 58 women (64.6±6.0 years; Fx = 55.2%) randomized to intervention or control groups. Again, dementia-related fear was associated with memory failures (r = .59, p<.001); fear was elevated in women with a dementia family history (p = .013, η² = .02). Fear was also associated with depression (r = .52, p<.001), and lower well-being and social participation (rs>-.59, ps<.001). Fear effects on depression and social participation were stronger for women with a dementia family history (ps<.027, η²s = .11). Fear scores decreased from pre- to post-intervention (p<.001, η² = .06). The biggest reduction was observed for women in the intervention group with a dementia family history (p = .004, η² = .03; Fig. 1B).

CONCLUSION: Older women with a family history of dementia are particularly fearful, and these fears are inversely related to mood, perceived memory functioning, social participation, and well-being. A low-cost, low-intensity intervention can reduce dementia-related fear and may be particularly beneficial for older women with a dementia family history. Targeting dementia-related fear in women has important implications in the era of biomarker disclosure and direct-to-consumer genetic testing.

PMID:39784516 | DOI:10.1002/alz.090823