Older people's knowledge and practice about lifestyle behaviors that may prevent vascular dementia

Abstract

This study examined the relationship between knowledge and practice of healthy lifestyle behaviors in the prevention of vascular dementia. Data presented here are derived from a convenience sample of 296 participants recruited through senior citizen agencies in Australia. Lifestyle was measured using the Health-promoting Lifestyle Profile (HPLP). Seven knowledge subscales were developed, consistent with the HPLP. Data were analyzed using multiple regression analysis. Correlations among the lifestyle and knowledge indicated statistically significant results. However, the strength of these associations was generally weak. Multivariate analysis found that six variables explained 20% of the variance in the lifestyle score. These included: knowledge of interpersonal relations, knowledge of physical activity, medical knowledge, medical history, self-assessment of general health, and use of alcohol. The results indicate that knowledge, by itself, does not necessarily ensure that people engage in self-practising healthy lifestyle behaviors, and those who experience illness and, perhaps exposure to risk factors, had higher HPLP scores. Recommendations for how older people can be supported to reduce some of the attitudinal barriers that reduce healthy lifestyle behaviors are discussed.

Introduction

It is now widely recognized that vascular dementia is the second most common dementia, after Alzheimer's disease (Hamdy et al., 1998) and that vascular dementias are preventable and associated with cerebrovascular disease (Lopez et al., 1997, Whitlock et al., 1997). Detection of persons with a high risk of developing vascular dementia (VaD) has been identified as a major preventative strategy (Dartigues et al., 1997). Prevention of vascular dementia is of critical importance, and, if public health strategies are not developed, we can continue to observe an increase in the prevalence of vascular dementia in the population, and associated increasing health care costs and caregiver burden (Kuller, 1996). Targeting efforts towards those who are cognitively and physically intact offer the best alternative to costly ‘aggressive treatment’ of the risk factors predisposing to this condition (Hamdy et al., 1998). This includes, among others, taking responsibility for health through early screening and management of hypertension, cardiac arrhythmias and diabetes, and reducing cholesterol in itself can lower the incidence of vascular dementia (Jorm, 1994, Shuaib and Boyle, 1994, Kuller, 1996, Dartigues et al., 1997, Lis and Garviria, 1997). In addition, self-practising healthy lifestyle behaviors in advanced age keeps the brain alert and healthy (Hachinski, 1992, Jorm, 1994, Shuaib and Boyle, 1994, Kuller, 1996, Dartigues et al., 1997, Lis and Garviria, 1997).

Research to date has focused on treatment and management of advanced irreversible dementia, with few studies examining the control of risk factors on the incidence of vascular dementia, which is surprising in view of current knowledge about self-care practices that promote healthy lifestyle behaviors (Butler et al., 1994, Kuller, 1996, Lis and Garviria, 1997, Commonwealth Department of Health and Aged Care, 1998, Garrett, 1999).

As a starting point to fill this gap, this study examines the relationship between lifestyle behaviors and knowledge about healthy lifestyle behaviors in older persons living in the community.