Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
J Alzheimers Dis. 2024;100(4):1315-1331. doi: 10.3233/JAD-240315.
Increased understanding of dementia risk-reduction and early detection of Alzheimer's disease and related disorders has spurred interest in the identification of risks for dementia, underlying putative biologies, or dementia itself. Implementation of such approaches require acceptability to the public. Research prior to 2012 indicated limited acceptability for population dementia screening. The changing landscape of dementia prevention research may influence recent perceptions. Additionally, perspectives from underserved populations, such as ethnic minorities and low socio-economic groups, are lacking.
In this systematic review, we sought published studies since 2012 on attitudes and preferences of people with dementia, carers and the general public from ethnic minorities and low socio-economic groups regarding dementia screening.
This review was preregistered on PROSPERO (CRD42023384115) and followed PRISMA guidelines. Key search terms were entered into five databases. Articles were included if they focused on population or risk screening for dementia via primary/community care-based assessments, and which included majority ethnic minority or low socio-economic groups or discretely considered these groups in data analysis. Data were synthesized narratively.
Seven studies reported perspectives of ethnic minorities regarding dementia screening; one study included people from low socio-economic groups. Results indicated that participants from ethnic minorities were willing to undergo dementia screening. Predictors of willingness included belief in benefits, desire to boost diversity, and to implement lifestyle changes. Unwillingness was associated with anxiety regarding results.
Although there seems to be high acceptability for screening in the studied groups, more research is necessary to explore the practical considerations for screening such as cultural and economic barriers, trust, and post-screening actions.
对痴呆风险降低和阿尔茨海默病及相关疾病的早期检测的认识不断提高，促使人们关注痴呆的风险因素、潜在的生物学机制或痴呆本身。此类方法的实施需要得到公众的认可。2012 年之前的研究表明，公众对人群痴呆筛查的接受程度有限。痴呆预防研究的不断变化可能会影响最近的认知。此外，缺乏来自服务不足人群（如少数民族和低社会经济群体）的观点。
在这项系统评价中，我们检索了自 2012 年以来发表的关于少数族裔和低社会经济群体中痴呆患者、照顾者和普通公众对痴呆筛查的态度和偏好的研究。
本研究在 PROSPERO（CRD42023384115）上进行了预先注册，并遵循了 PRISMA 指南。主要检索词输入到五个数据库中。如果文章侧重于通过初级/社区护理为基础的评估进行人群或风险筛查痴呆，且包括多数少数民族或低社会经济群体，或在数据分析中明确考虑这些群体，则纳入研究。数据通过叙述性综合进行分析。
有 7 项研究报告了少数民族对痴呆筛查的看法；有 1 项研究纳入了来自低社会经济群体的参与者。结果表明，少数民族参与者愿意接受痴呆筛查。愿意进行筛查的预测因素包括对益处的信念、增加多样性的愿望，以及实施生活方式的改变。不愿意进行筛查与对结果的焦虑有关。
尽管研究群体对筛查的接受程度似乎很高，但仍需要更多的研究来探索筛查的实际考虑因素，如文化和经济障碍、信任和筛查后的行动。
