The Intervention Effect Of Cognitive Health Education On Community People With Subjective Memory Complaints

Subjective memory complaints(SMC)refer to everyday concerns cited by people both with and without objective evidence of memory impairment,although its definition has not been standardized worldwide,it was proposed as the Pre-mild cognitive impairment(Pre-MCI)between normal and dementia,anticipating by approximately 15 years the subsequent onset of MCI.Therefore,people with SMC should be the focus population of prevention dementia.However,studies from home and abroad on cognitive health education intervention,especially research for the publicity of dementia risk factors and change of personal lifestyle and health behavior,is very lack.This present study is aim to investigate knowledge related to dementia risk and beliefs of dementia among general community population,exploring their influence factors,and to evaluate the effect of the cognitive health education intervention on dementia risk related knowledge,the beliefs of lifestyle and behaviors change for reducing dementia risk(beliefs of dementia risk control for short),the health promoting lifestyle and memory function of community people with SMC.Objective1.To investigate and analyze knowledge about dementia risk reduction and beliefs of dementia of community people,providing reference for the later cognitive health education program.2.To assess the influence of cognitive health education on dementia risk related knowledge,beliefs of dementia risk control,the health promoting lifestyle and memory function of community people with SMC.Method1.Through convenience sampling,the self-designed questionnaire on beliefs of dementia and knowledge about dementia risk reduction were issued to subjects who took annual medical examination in any of 22 Community Health Service Centers(CHSC)in Shapingba district of Chongqing from March to June in 2015.SPSS 19.0 and STATA version 14.0 was used,with the significance level set at 0.05(two-tailed)for all statistical analyses.2.Subjects who took annual medical examination in three CHSCs of Chongqing from June to October in 2015 were screened with screening scales by face-to-face interview.Those who meet the research criteria were randomized to experimental group or control group.Participants in the control group only received routine health instruction and medical and health services.Based on the control group,people in the experimental group received cognitive health education.Respectively,at three time points of before the intervention(T1),after the group intervention(T2)and the telephone follow-up(T3)to evaluate all participants’ knowledge of dementia risk,beliefs of dementia risk control,the health promoting lifestyle and memory function by using four instruments including the questionnaire on dementia risk reduction,motivation to change lifestyle and health behaviour for dementia risk reduction(MCLHB-DRR)scale and health promoting lifestyle profile II(HPLP-II);at two time points of before the intervention(T1),after the telephone follow-up(T3)to evaluate their daily life memory function by the Rivermead Behavioural Memory Test Second Edition(RBMT-II).SPSS software version 19.0 was used to describe qualitative data as numbers(proportions)or quantitative data as means(standard error)or median(interquatile range).Mann-Whitney for 2 independent samples tests,Chi aquare(χ2),and repeated measures analysis of variance(ANOVA)were used where appropriate.Results1.Status of beliefs of dementia and knowledge about dementia risk of community residents and influence factor analysis1.1 The status of beliefs of dementia and knowledge about dementia risk of respondentAmong the 3443 participants,although 55.6% have received knowledge about dementia,only a small number of people reported they knew ways to reduce dementia risk(18.8%),and the proportion of the methods suggested range from 0.6%~12.3%,with physical activity as the most frequently mentioned one.Additionally,the proportion of individuals expressing perceived susceptibility and personal fear of dementia accounted for 11.7% and 36.8%,respectively.1.2.Multivariable analysis of factors associated with knowledge about dementia risk and beliefs of dementiaBinary logistic analysis was used with “whether or not known” and “whether or not suggest concrete methods ” as variable(1 = “yes”;0 = “no”)and sociodemographic factors(including sex,age,education,family economic condition,self-rated health,contact with dementia,experience of accepting knowledge of dementia and presence of subjective memory complaints,i.e.SMC)as independent variable.The result showed sex,age,education status,family economic condition,contact with dementia,exposure to knowledge of dementia and presence of SMC were influence factors of knowledge of dementia risk.Binary Logistic Analysis was used with “whether agree” as variable(1 = “agree”;0 = “disagree”)and sociodemographic factors as independent variable).The result showed sex,age,education status,contact with dementia,exposure to knowledge of dementia and presence of SMC were influence factors of beliefs of dementia.2.The intervention effect of cognitive health education based on the dementia risk control2.1 The influence of cognitive health education on dementia risk related knowledge of community people with SMC.The result of χ2 tests showed that after the group intervention and telephone follow-up,awareness rates of suggesting methods to reducing dementia risk of the experimental group and control group were different significantly(P<0.05).2.2 The influence of cognitive health education on beliefs of dementia risk control,and the health promoting lifestyle of community people with SMC.Mann-Whitney for 2 independent samples tests revealed that the total scores of MCLHB-DRR and total scores of subscale of HPLP-II between the treatment group and control group were different significantly after the group intervention and individual intervention(P<0.05).2.3.The influence of cognitive health education on memory function of community people with SMC.The total scores of RBMT-II immediate and delayed recall of a story and faces recognition in experimental group were significantly higher(P< 0.05)than those in controls at the same time point of post-intervention.Interaction diagrams demonstrated that before and after the cognitive health education,as the change of time,the total score of RBMT-II of the control group was on the decline,while the experimental group’s total score of RBMT-II was on the rise.Conclusions:1.Knowledge of dementia risk of the community people including those with SMC was low,especially there is considerable scope to increase public understanding of the benefits that can be gained for brain health from actions to protect and improve vascular health.It is necessary and urgent to carry out the cognitive health education in community especially education for focus people.2.Except for the low age,higher level of education,contact with dementia and no presence of SMC,people who received dementia-related knowledge education have more knowledge of dementia risk,suggesting that health education intervention to enhance community residents’ knowledge on dementia risk and prevention is feasible.3.The cognitive health education designed in the present study can improve the knowledge of dementia risk,beliefs and attitudes to change lifestyle for dementia risk control,the health promoting lifestyle and memory function of community people with SMC(people who at high risk of dementia).