Dementia knowledge and attitudes from Third-age university participants

Overview

Aim: The aim of our cross-sectional study was to find out what knowledge seniors have about dementia and attitudes towards dementia and whether these attitudes and knowledge differ according to selected factors. Materials and methods: The research set consisted of 269 participants from the University of the Third Age in Ostrava who were over 60 years of age. The Dementia Knowledge Scale and The Scale of Attitudes toward People with Dementia and their Care (APDC) were used for data collection. Statistical evaluation was performed using the Mann-Whitney test and Spearman correlation coefficient. Results: On average, seniors knew five out of eight symptoms of dementia and five out of ten risk factors. Seniors with experience in caring for a person with dementia (P = 0.002) and women (P = 0.043) had better knowledge about the symptoms of dementia. Men reported greater knowledge about risk factors for dementia (P = 0.028). The greatest ignorance of risk factors was in the areas of obesity, high blood pressure, diabetes, and smoking. No association was found between knowledge and attitudes toward dementia. Conclusions: Increasing the knowledge of seniors about the symptoms and risk factors of dementia can lead to greater adherence to preventive measures and early recognition of the disease. At the same time, it is appropriate to include interventions shaping seniors‘ attitudes towards dementia and care for people with dementia in prevention programmes.

Keywords:

risk factor – dementia – attitude – Knowledge – older people

This is an unauthorised machine translation into English made using the DeepL Translate Pro translator. The editors do not guarantee that the content of the article corresponds fully to the original language version.

 

Introduction

According to the International Classification of Diseases, dementia can be characterized as "a syndrome caused by a disease of the brain, usually chronic or progressive in nature, in which many higher neural cortical functions, including memory, thinking, orientation, comprehension, calculation, learning, language, and judgment, are impaired to a degree that limits self-sufficiency and lasts for at least 6 months" [1]. Dementia has many causes, the most common of which is Alzheimer's disease [2-5]. Due to the significant increase in the number of people with dementia worldwide, the World Health Organization declared dementia prevention a public health priority as early as 2012 [6]. There are approximately 50 million people living with dementia worldwide and this number is projected to increase to 152 million by 2050 due to population ageing [7,8]. In the Czech Republic, almost 150,000 people suffer from some form of dementia and the number is increasing. According to the latest medical yearbook from 2021, 91,924 patients were treated for Alzheimer's disease alone. The largest proportion of patients were over 80 years of age, two thirds were women [9]. Thus, the likelihood of developing dementia increases significantly with age, especially in those over 65 years of age [10].

Although it is currently not possible to cure dementia, there is scientific evidence of possible risk reduction and protective factors (e.g. healthy lifestyle, non-smoking, physical and mental exercise, cognitive rehabilitation) that can delay or prevent the risk of dementia [7,11-13]. Livingson et al. [7] in the Lancet report stress that it is never too late to prevent dementia. Preventive measures need to be directed at early (people under 45 years), middle (45-65 years) and later ages (over 65 years). Even preventive measures in old age can influence the triggering of neuropathological development.

In the Czech Republic, a National Action Plan for Alzheimer's disease and similar diseases for 2020-2030 [14] has been developed to promote awareness, prevention, increase access to early diagnosis and subsequent health and social support. The fourth strategic objective focuses on awareness of dementia, its prevention, symptoms and the needs of people living with dementia and family caregivers. The objective is based on the premise that a major shortcoming is the low awareness in the general population, as well as the low availability of dementia education programmes for non-health professions, but especially for informal carers. The elderly are a target group in which prevention should not be neglected. Prevention programmes should be designed to motivate the target group to change their health-related behaviour.

Our research was based on a model that is frequently used in health behaviour research, namely the Health Belief Model [15]. An individual's willingness to change his or her health-related behaviour is influenced by the degree of perceived susceptibility to illness (threat) and perceived severity (consequences of illness), ratings of perceived benefits of preventive measures, and potential barriers. The model also assumes a trigger for health-promoting behaviour, which may be both internal (e.g. memory problems in old age) and external (e.g. educational events for the elderly). Sufficient knowledge about risk factors for dementia may lead to a higher perceived susceptibility to the disease and its severity, and thus to a higher motivation to adhere to preventive measures. They may also be beneficial for detecting the first signs of dementia and ensuring early diagnosis and treatment [16]. Shaping attitudes towards dementia may influence the formation of more positive attitudes towards people with dementia and their care. This can reduce the stigma of dementia and increase the dignity of people with dementia [17]. A systematic review by Cahil et al [18] found that in the vast majority of studies the public had inadequate knowledge and perceptions of dementia. The most common misconception was that dementia is a normal part of ageing.

The aim of our cross-sectional study was to determine the knowledge of seniors attending the University of the Third Age in Ostrava about the symptoms and risk factors of dementia and their attitudes towards dementia and dementia care. The study was also designed to reveal whether these attitudes and knowledge differ by gender, occupation, experience of caring for a person with dementia and whether there is a link between the level of knowledge about dementia and attitudes towards dementia.

 

Material and methods

Design studies

An observational cross-sectional study was conducted.

 

Research file

The research population consisted of seniors attending activities at the Centre for Healthy Ageing at the Faculty of Medicine of the University of Ostrava, the University of the Third Age of the University of Ostrava and the University of the Third Age of the University of Mining. These were seniors over 60 years of age, living at home. Persons under 60 years of age, persons with visual deficits preventing completion of the questionnaire and seniors with moderate and severe cognitive deficits (Montreal Cognitive Test score ≤ 17 points) were excluded. Cognitive function of seniors was assessed in our research project. All seniors participating in the above-mentioned activities between January and May 2023 (n = 374) were contacted for participation in the study. A total of 269 seniors agreed to complete the questionnaires and met the given selection criteria and were included in the research population. The return rate of the questionnaires was 72%.

 

Data collection

The Dementia Knowledge Scale (DKS) was used to assess knowledge, which contains 18 statements with a true/false/not sure response option [19]. Eight statements focus on knowledge about symptoms of dementia and ten statements focus on knowledge about risk factors that may increase or decrease the likelihood of developing dementia. In each domain (symptoms of dementia and risk factors), a score comprising the sum of the correct answers is assessed. The domain scores range from 0-8 points in the dementia symptoms domain and 0-10 points in the risk factors domain. A higher score indicates greater knowledge in the domain.

The Scale of Attitudes toward People with Dementia and their Care (APDC) [20] was used to assess attitudes toward dementia. The APDC scale includes nine formulated attitudes with response options on a 5-point Likert scale ranging from 1 (strongly agree) to 5 (strongly disagree). The statements are grouped into two domains: 1. interaction (5 items) and 2. care (4 items). The total score ranges from 9-45. Scores in the interaction domain range from 5-25 points, and in the care domain range from 4-20 points. Higher scores indicate better attitudes towards dementia.

Scale translation and cultural adaptation were performed as recommended by Beaton et al [21]. Both scales were translated into the Czech language using the back-translation method. Subsequently, the individual statements were discussed with five experts in the fields of nursing, geriatrics and psychiatry in order to modify the wording of the statements to make them understandable for the Czech environment.

Neither validity nor reliability has been published for the original versions of both scales. Wu et al [16,22] published the reliability of the Chinese version of both scales using Cronbach's alpha (a ), which was found to be satisfactory (DKS dementia symptoms domain scalea = 0.74; risk factors domaina = 0.84; APDC scalea = 0.77). In our research, we also assessed the reliability of the Czech version of both scales using Cronbach's alpha. Satisfactory reliability was found in both domains of the DKS scale (dementia symptoms:a = 0.773; risk factors domain:a = 0.762) and the APCD scale in the Czech version (a = 0.708).

 

Statistical analysis

Data were evaluated using the statistical program SPSS (v. 29) (IBM, Armonk, NY, USA). Descriptive statistics -⁠ absolute frequency (n), relative frequency (%), arithmetic mean and standard deviation (SD) were used for basic data evaluation. Normality of the data was tested using the Shapiro-Wilk test (p < 0.001). The data did not have a normal distribution, so the median (med) and interquartile range (IQR) were also used. The difference between groups was tested using the Mann-Whitney U test. The association between domains was tested using Spearman's correlation coefficient. The level of statistical significance was set at 5%.

 

Results

Demographic composition of the research population

Of the 269 seniors, 50 were men and 219 were women. The mean age was 70.3 years (SD = 4.4; min-max = 61-86 years). Most were married (49.8%), followed by widow(er)s (26.4%), divorced (20.8%), and least were single (3%). 39.8% of the seniors surveyed lived alone in the household. 13% of seniors worked full or part time. 15.2% worked on a contract for work (FTE) / contract for work (FTE). Most seniors (71.7%) were no longer working at all. 72.9% of the respondents knew at least one person suffering from dementia. 37.9% of seniors reported experience of caring for a person with dementia.

 

Assessment of knowledge about dementia

The mean score on knowledge of dementia symptoms was found to be 4.9 (SD = 2.8; median = 5.0; IQR = 3.5-7.0). The mean score in the domain "knowledge of risk symptoms" was found to be 4.8 (SD = 2.3; median = 5.0; IQR = 3.0-7.0). All eight symptoms of dementia were correctly identified by 18.6% of seniors. Five or more symptoms were correctly reported by 58.4% of seniors. 6.7% of seniors did not indicate any symptom correctly.

In the "knowledge of risk factors" domain, only 4 (1.5%) seniors correctly listed all ten risk factors. Five or more risk factors were mentioned by 51.7% of seniors. Only 2 (0.7%) seniors did not list any risk factor correctly. Table 1 shows the results for each item. Of the symptoms of dementia, seniors most frequently correctly reported the items "putting things in the wrong place" (78.8%) and "difficulty recognizing people" (75.5%). In contrast, they least frequently reported the symptom "feeling extremely tired" (32%).

More than half (59.5%) of seniors correctly reported that it is possible to reduce the risk of dementia. Most seniors correctly identified the protective factors for dementia as social activity (85.5%) and regular exercise (66.9%). Seniors were least likely to cite high blood pressure (26%) and obesity (26%) as risk factors.

We also investigated differences in knowledge about dementia according to selected factors. Women demonstrated more knowledge of dementia symptoms (p = 0.043). On the other hand, men had more knowledge in the area of risk factors (p = 0.029). Furthermore, there was a statistically significant difference in knowledge of dementia symptoms according to experience of caring for a person with dementia (p = 0.002). More knowledge was reported by seniors who had experience of caring for a person with dementia (Table 2). Using Spearman's correlation coefficient, there was no association between age and knowledge of dementia symptoms or risk factors.

 

Assessment of attitudes towards dementia

The overall mean APDC dementia attitude score was found to be 25.9 (SD = 2.9; min-max = 14-40; med. = 26; IQR = 23-29). A mean score of 14.4 (SD = 4.6; min-max = 7-23; med. = 15; IQR = 13-16) was found in the "interaction" domain and 11.5 (SD = 2.6; min-max = 5-19; med. = 11; IQR = 10-13) in the "care" domain. Seniors most frequently disagreed with the statement "There is no point in trying to talk to people with dementia because they are not able to understand." (64.7%). Conversely, they most frequently agreed with the statement "Once a person gets dementia, they lose the personality you knew." (76.2%) and "All you can do for someone with dementia is keep them clean, healthy and safe." (61%). The ratings for each item are shown in Table 3.

Better attitudes toward dementia were reported by seniors who had no experience caring for a person with dementia and seniors who did not know any person with dementia. However, the differences were not statistically significant. There were also no statistically significant differences by gender, occupation or marital status (Table 4). Furthermore, there was no association between age and attitudes towards dementia.

 

Relationship between knowledge and attitudes towards dementia

The relationship between knowledge and attitudes of the elderly towards dementia was investigated using Sperman's correlation coefficient. No association was found between knowledge of dementia symptoms and risk factors and attitudes towards dementia. There was an association between attitudes in the "interaction" domain and in the "care" domain (r = 0.398; p < 0.001) and also between knowledge of dementia symptoms and knowledge of risk factors (r = 0.357; p < 0.001) (Table 5).

 

Discussion

Although there is now scientific evidence of potentially modifiable risk factors for dementia [7,23-26], the extent to which these risk factors are known among the general population is unclear in many countries [27].

Within the National Action Plan for Alzheimer's disease and similar diseases for 2020-2030 [14], experts point out that there is very little knowledge of dementia in Czech society today. Only people who have encountered the manifestations of dementia in their family circle have knowledge; the rest of society often perceives the disease in a distorted way, as a harmless distraction where old people forget. This ignorance can lead to underestimating the first signs of the disease, when the patient could have already been diagnosed and treatment could have been started. In our research, it was confirmed that seniors who had experience in caring for a person with dementia had more knowledge about the symptoms of dementia. However, they were not shown to also have knowledge of risk factors. Similarly, in an Irish study [28], relatively good knowledge of dementia but limited knowledge of specific risk factors was found among the Irish adult population. In contrast, a Dutch study demonstrated both poor knowledge of dementia and risk factors for dementia [29].

Knowledge of the influential risk factors for cognitive dysfunction is an important part of prevention. Livingston et al. [7] published a total of 12 influential risk factors, by controlling which, approximately 40% of the global number of dementias could theoretically be prevented or slowed down. The first nine factors were published in 2017 and are: lower education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes and low social contact. Now the authors add three more risk factors for dementia with more recent, compelling evidence. These factors are excessive alcohol consumption, traumatic brain injury and air pollution. Silva et al [11] cite an additional risk factor, namely, less than ideal weight (body mass index [BMI] < 20 kg/m²). Weight loss in advanced age occurs concomitantly with other comorbidities and often indicates poor health and may even precede the onset of dementia within 10 years.

Our research investigated knowledge of nine modifiable risk factors and one question to determine the possibility of influencing the development of dementia. Almost 60% of the seniors in our survey believed that the risk of dementia could be reduced. Zulke et al [27] came to a higher figure of 68% in a German study. In the UK, 67% was found [19]. In a study in Iceland [30], up to 90% of adult participants recognised 8 of the 11 symptoms of dementia, but only 50% of research participants believed that the risk of developing dementia could be influenced.

Seniors in our, German [27] and British [19] studies consistently reported physical activity as a protective factor and social isolation as a risk factor. They had insufficient knowledge about cardiovascular risk factors such as high blood pressure or obesity, diabetes and smoking. While control of systolic blood pressure is particularly useful for delaying or preventing dementia in middle age (130 mm Hg or lower) [29], stopping smoking or being active may also help to reduce the risk of dementia later in life [7].

Recommendations for prevention programmes for the elderly focus on cognitive, physical and social activity [25,26,31-34], despite the fact that there is little scientific evidence for any specific activity protecting against dementia. Regular exercise and activity are likely to protect against dementia by reducing obesity, diabetes, cardiovascular risk or depression [7]. Knowledge of depression as a risk factor for dementia was reported by almost half of the seniors surveyed in our study. In the British study, this was only one third of the respondents [19].

In our research, women and seniors who had experience caring for a person with dementia had a deeper understanding of the symptoms of dementia. Greater knowledge of risk factors was demonstrated in men. Other factors such as age, marital status or occupation did not affect the seniors' knowledge. Similarly, previous studies have found greater knowledge of dementia symptoms in women [19,30] and risk factors in men [20,27]. Zulke et al [27] found that women had higher confidence in prevention than men. They also demonstrated a difference in knowledge of risk factors according to education. Seniors with higher education were more likely to know risk factors related to individual behaviour (diet, smoking, physical activity), people with lower education external factors (air pollution). Previous studies have also shown that people with less education are more likely to consider external risk factors for disease [35]. The association between lower education and less knowledge about dementia has also been demonstrated in other studies [16,20,28-30], as have differences in knowledge about dementia and experience of caring for a person with dementia [20].

In our research, we found no differences in attitudes to dementia by age, gender, marital status, employment or experience of caring for a person with dementia. More positive attitudes towards caring for people with dementia have been found in previous studies among younger people [16,19] and seniors who have experience of caring for a person with dementia [19]. McParland et al [20] reported that women were more likely to believe that people lose their personality after having dementia. In contrast, men were more likely to say that all you can do for someone with dementia is to keep them clean, healthy and safe. Furthermore, people living alone without a partner reported worse attitudes towards people with dementia than those who lived with a partner [20].

 

Limitations of the study and recommendations for future research

The limitation of our study can be considered to be the selection of the research population. We did not randomly select the population of seniors, but the target group of our research was seniors attending the University of the Third Age in Ostrava. Therefore, the results cannot be generalized to the entire population of seniors. It can be assumed that seniors not participating in educational activities may have lower knowledge about dementia. For further research, we recommend focusing also on seniors who do not participate in educational activities for seniors, e.g. through general practitioners, and on the adult population. Conducting random sampling in the elderly population may be problematic. In addition, we recommend including follow-up of other factors that might be related to knowledge and attitudes towards dementia, such as education, type of employment, level of health literacy, physical and mental state, or willingness to change health-related behaviour. Further research can be directed at determining the effectiveness of education and prevention programmes to increase knowledge about dementia and improve attitudes towards dementia.

 

Conclusion

Our research found that seniors had insufficient knowledge about the symptoms and risk factors of dementia. Increasing seniors' knowledge of the symptoms of dementia, including increased knowledge of both risk and protective factors for dementia, may help to improve awareness of the warning signs of the disease and subsequently lead to earlier diagnosis. Early diagnosis and early initiation of treatment may lead to a greater likelihood of maintaining the elderly's self-sufficiency and reduced social burden [36].

In order to improve the awareness of dementia among seniors, we recommend including the topic of dementia in the Universities of the Third Age, both in terms of symptoms for early diagnosis and in terms of risk and protective factors for dementia prevention. In addition, we recommend motivating the elderly to participate in similar educational activities. As our research did not find an association between knowledge about dementia and attitudes towards dementia, we recommend including psychosocial activities focusing on attitudes towards dementia among prevention strategies. In addition, we recommend that the Center for Promoting Healthy Aging also create educational programs and activities for seniors who do not participate in the educational activities of the University of the Third Age and offer interventions to seniors focused on modifiable risk factors to address the expected increase in the number of individuals affected by dementia.

 

Ethical aspects

The study was conducted in accordance with the Helsinki Declaration of 1975 (and its revisions of 2004 and 2008). The study was approved by the local ethics committee of the Faculty of Medicine of the University of Ostrava (date of approval: 16 June 2020, No. 14/2020). Completion of the questionnaire was anonymous. At the beginning of the questionnaire, study participants were informed that by completing and submitting the questionnaire they agreed to anonymous data processing.

 

Grant support

This work was supported by the grant NU21-09-00067 from the Ministry of Health of the Czech Republic. All rights under intellectual property protection regulations are reserved.

 

Conflict of interest

The authors declare that they have no conflict of interest in relation to the subject of the paper.

 

Table 1: Assessment of seniors' knowledge of symptoms and risk factors of dementia.

Items	The Truth n (%)	Lie n (%)	I don't know n (%)
Knowledge of symptoms
difficulty in recognising people	203 (75,5)	36 (13,4)	30 (11,2)
putting things in the wrong place (e.g. shoes in the fridge)	212 (78,8)	46 (17,1)	11 (4,1)
slower thinking	189 (70,3)	50 (18,6)	30 (11,2)
loss of the concept of time (e.g. confusion of day and night)	191 (71,0)	49 (18,2)	29 (10,8)
the feeling of being lost in a new place	189 (70,3)	48 (17,8)	32 (11,9)
feelings of extreme fatigue	86 (32,0)	85 (31,6)	98 (36,4)
easy loss of patience	120 (44,6)	71 (26,4)	78 (29,0)
feelings of depression	129 (48,0)	74 (27,5)	66 (24,5)
Knowledge of risk factors
it is not possible to reduce the risk of dementia	44 (16,4)	160 (59,5)	65 (24,2)
high blood pressure increases the chance of developing dementia	70 (26,0)	80 (32,7)	111 (41,3)
a parent's dementia increases the likelihood of...	91 (33,8)	77 (28,6)	101 (37,5)
Smoking increases the likelihood of dementia	96 (35,7)	76 (28,3)	97 (36,1)
drinking alcohol increases the likelihood of dementia	166 (61,7)	47 (17,5)	56 (20,8)
regular exercise reduces the likelihood of dementia	180 (66,9)	40 (14,9)	49 (18,2)
depression increases the likelihood of dementia	131 (48,7)	33 (12,3)	105 (39,0)
diabetes (diabetes increases the likelihood of dementia	88 (32,7)	75 (27,9)	106 (39,4)
obesity increases the likelihood of dementia	70 (26,0)	91 (33,8)	108 (40,1)
Social activity reduces the likelihood of dementia	230 (85,5)	15 (5,6)	24 (8,9)

n -⁠ number of

 

 

Table 2. Assessment of differences in knowledge about symptoms and risk factors of dementia according to selected factors.

		Knowledge of symptoms			Knowledge of risk factors
		med. (IQR)	average (SD)	p	med. (IQR)	average (SD)	p
has experience of caring for a person with dementia	Yes	4 (4-7)	5,2 (2,2)	0,002	5 (3-7)	4,9 (2,3)	0,233
	No	4 (2,5-6)	4,2 (2,6)		4 (3-6)	4,5 (2,2)
knows a person with dementia	Yes	6 (4-7)	5,1 (2,4)	0,095	5 (3-7)	4,7 (2,1)	0,905
	No	5,5 (4-7)	4,8 (2,4)		5 (3-7)	4,8 (2,4)
Gender	man	4 (3-6)	4,4 (2,3)	0,043	5 (5-7)	5,3 (2,2)	0,028
	Woman	5 (7-7)	5,0 (2,4)		4 (3-6)	4,6 (2,3)
employment	Yes	5 (3-7)	4,8 (2,2)	0,925	5 (3-7)	4,6 (1,9)	0,507
	No	5 (4-6)	4,9 (2,5)		4 (3-6)	4,8 (2,4)
lives alone in the household	Yes	6 (3-7)	5,1 (2,5)	0,520	4 (3-7)	4,9 (2,5)	0,873
	No	5 (4-6,3)	4,8 (2,3)		5 (3-6)	4,7 (2,2)

IQR -⁠ interquartile range; SD -⁠ standard deviation

 

 

 

Table 3. Evaluation of the attitudes of the elderly towards dementia.

Attitudes	diameter (SD)	1 + 2 n (%)	3 n (%)	4 + 5 n (%)
Domain "interaction"
Once a person gets dementia, they lose the personality you knew.	2,0 (2,0)	205 (76,2)	40 (14,8)	24 (9,0)
If a person has severe dementia, their life is no longer worth living.	3,1 (1,1)	70 (26,0)	88 (32,7)	111 (41,2)
Telling someone they have dementia is of little or no benefit.	2,7 (1,0)	122 (45,4)	96 (35,7)	51 (18,9)
People who have just been diagnosed with dementia are unable to make decisions about their own care.	3,0 (1,1)	99 (36,8)	73 (27,1)	97 (36,0)
There is no point in trying to talk to people with dementia because they are not able to understand.	3,6 (1,0)	37 (13,7)	58 (21,6)	174 (64,7)
Domain "care"
All you can do for someone with dementia is to keep them clean, healthy and safe.	2,5 (1,2)	164 (61)	38 (14,1)	67 (24,9)
Once someone is diagnosed with dementia, they are not treated as a thinking human being.	3,3 (1,1)	55 (20,5)	76 (28,3)	138 (51,3)
People with dementia are like children and need to be treated as if they were children.	2,5 (1,0)	151 (56,2)	65 (24,2)	53 (19,7)
It's better for people with dementia and their families if they are cared for in the sanitary facilities.	3,1 (0,9)	68 (25,3)	117 (43,5)	84 (31,2)

1 -⁠ strongly agree; 2 -⁠ agree; 3 -⁠ neither agree nor disagree; 4 -⁠ disagree; 5 -⁠ strongly disagree

n -⁠ number; SD -⁠ standard deviation

 

 

Table 4. Evaluation of differences in the attitudes of the elderly towards dementia according to selected factors.

		Total APDC score			Domain "interaction"			Domain "care"
		median (IQR)	average (SD)	p	median (IQR)	average (SD)	p	median (IQR)	average (SD)	p
has experience in caring for a person with...	Yes	25 (22-30)	25,6 (5,4)	0,247	14 (12-16)	14,2 (3,3)	0,122	11 (9-13)	11,5 (2,8)	0,466
	No	26 (23-29)	26,0 (4,0)		15 (13-16)	14,6 (2,6)		11 (10-13)	11,4 (2,4)
knows a person with dementia	Yes	25 (23-29)	25,8 (4,8)	0,340	14,5 (13-16)	14,4 (3,0)	0,444	11 (9,3-13)	11,4 (2,7)	0,281
	No	26 (24 -⁠ 28.5)	26.1 (3.9)		15 (12-16)	14.5 (2.6)		12 (10-12.5)	11.6 (2.2)
Gender	man	25,5 (23-29)	25,7 (4,4)	0,372	15 (13-16)	14,5 (2,9)	0,434	11 (9-13)	11,2 (2,7)	0,220
	Woman	26 (23-29)	25,9 (4,6)		14 (13-16)	14,4 (2,9)		11 (10-13)	11,5 (2,5)
employment	from	26 (24-30)	26,1 (4,5)	0,338	15 (13-16)	14,5 (2,9)	0,395	11 (10-13)	11,6 (2,6)	0,327
	No	25 (23-29)	25,8 (4,6)		14 (12,5-16)	14,4 (2,9)		11 (10-13)	11,4 (2,5)
lives alone in the household	Yes	25 (23-29)	25,8 (4,8)	0,514	14 (12-16)	14,1 (3,0)	0,089	12 (10-13)	11,7 (2,7)	0,389
	No	26 (23-29)	25,9 (4,4)		15 (13-16)	14,6 (2,8)		11 (10-12,3)	11,3 (2,5)

APDC -⁠ The Scale of Attitudes toward People with Dementia and their Care; IQR -⁠ interquartile range; SD -⁠ standard deviation

 

 

Table 5: Relationship between knowledge and attitudes of seniors towards dementia (r).

		Attitudes -⁠ APDC scale			Knowledge -⁠ DKS scale
		Interactions	care	total score	Symptoms	risk factors
Attitudes -⁠ APDC scale	Interactions	1,000
	care	0,398*	1,000
	total score	0,844*	0,806*	1,000
Knowledge -⁠ DKS scale	Symptoms	-0,001	0,009	0,011	1,000
	risk factors	-0,049	0,024	-0,005	0,357*	1,000

*p < 0,001

APDC -⁠ The Scale of Attitudes toward People with Dementia and their Care; DKS -⁠ Dementia Knowledge Scale; r -⁠ Spearman's correlation coefficient