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Understanding Motivation to Engage in Healthy Lifestyle Behaviors for Dementia Risk Reduction in Midlife Using a Person-Centered Approach
Simone, Stephanie
Simone, Stephanie
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2025-08
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Psychology
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https://doi.org/10.34944/tdpt-6882
Abstract
OBJECTIVE: The number of individuals diagnosed with dementia is expected to reach over 135 million by 2050 (World Health Organization, 2022). Without a cure, research has focused on identifying ways to prevent or reduce dementia risk. The brain changes associated with Alzheimer’s disease (AD) begin several years before the onset of clinical symptoms and disability (Jack et al., 2013), offering a window of opportunity to engage in interventions to delay or prevent clinical symptoms and extend functional independence. Midlife appears to be a critical time during which certain modifiable risk factors and healthy lifestyle behaviors are most impactful for reducing dementia risk or delaying its onset. However, engaging and maintaining healthy behaviors requires considerable motivation in midlife, as benefits are not readily observed, and risks may not be relevant for up to decades later. The beliefs and knowledge associated with engagement and adherence to healthy lifestyle behaviors remain poorly understood and have not been investigated using person-centered approaches. The present study identified subgroups of participants in midlife with similar profiles of beliefs and knowledge about dementia prevention using latent profile analysis and examined associations between latent profiles and demographic features, extrinsic factors, and engagement in healthy lifestyle behaviors.
METHODS: Three-hundred forty-seven middle-aged adults completed an online survey assessing demographic characteristics and a battery of self-report measures evaluating beliefs and knowledge related to dementia and dementia prevention, including motivation to engage in healthy lifestyle changes for dementia risk reduction. Participants also reported whether they had certain AD risk factors (e.g., hypertension, high cholesterol, obesity), and how often they engaged in dementia risk-reducing behaviors (physical activity, cognitive activity, sleep quality, social activity). Latent profile analysis identified subgroups of participants based on measures of beliefs and knowledge related to dementia risk reduction (Aim 1). Differences between latent profiles were examined on demographic characteristics and extrinsic factors (e.g., family history of AD and other risk factors), and profiles were validated on measures of frequency of engagement in healthy behaviors (Aim 2).
RESULTS: Latent profile analysis revealed four distinct profiles: Profile 1Low Motivation/No Concern, Profile 2High Motivation/Low Knowledge, Profile 3Moderate Motivation/No Concern, and Profile 4Average-Low Avg Motivation/Pessimistic (Aim 1). Profile 1 included older individuals with the lowest dementia risk. They reported the best sleep quality and were the least lonely. Profile 2 included younger participants with high annual incomes relative to the other profiles and the general US population who were more likely to be current/past caregivers for someone with AD and more likely to have been told that they were at increased risk of dementia. Profile 2 reported being the most cognitively active but were the loneliest. Profile 3 included older participants who were current/past caregivers for someone with AD and who reported moderate engagement in all healthy lifestyle behaviors. Finally, Profile 4 was a group of individuals with lower incomes and greatest physical and mental health problems. Profile 4 reported the least engagement in all healthy lifestyle behaviors (Aim 2).
CONCLUSIONS: Results provide preliminary evidence for distinct subgroups of middle-aged adults with similar patterns of intrinsic factors and different types and levels of engagement in healthy lifestyle behaviors for dementia risk reduction. Specific subgroups, namely Profile 2High Motivation/Low Knowledge and Profile 4Average-Low Avg Motivation/Pessimistic, are ideal targets for interventions and would likely benefit differentially from tailored interventions to reduce dementia risk. Insights gained from this study may be used to inform the design of dementia prevention programs and policies targeted at people in midlife. Future studies should attempt to replicate these latent profiles in other samples to confirm the generalizability of these findings and conduct longitudinal assessments of cognition and stability of engagement in healthy lifestyle behaviors to assess dementia risk and incidence across the lifespan.
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