Exploring the views of key stakeholders on dementia risk prediction in primary care in areas of socioeconomic deprivation: a qualitative study.

Abstract

There is growing interest in personalised approaches to dementia risk assessment and prevention. Risk prediction tools can estimate an individual's likelihood of developing dementia, but none are currently used clinically. Socioeconomic deprivation may reduce opportunities for individuals to engage in healthy behaviours that support brain health even if risk is determined. To explore the potential challenges and facilitators in introducing dementia risk prediction tools into UK general practice, with an emphasis on those living in areas of socioeconomic deprivation. This was a qualitative study set in general practices from three geographical areas of England (Greater Manchester, North East, and South East). Semi-structured qualitative interviews explored the views of key stakeholders about the use of risk prediction tools for future dementia. These were analysed using thematic analysis. In total, 71 participants were purposively sampled and interviewed (31 primary care staff; 40 patients). We identified four themes that influenced engagement with dementia risk prediction in general practice: 1) risk as an idea; 2) patient views on the impact of, and choice around, risk screening; 3) embedding risk prediction into clinical consultations; and 4) wider system-level engagement to support adoption of risk prediction tools to prevent dementia. Dementia risk assessment presents distinct challenges compared with other areas of medicine. Increased public awareness around dementia prevention and risk reduction can facilitate this process. When developing interventions, there needs to be a recognition of the need for a whole-systems approach that supports individuals to adopt strategies to reduce their risk.