Primary prevention of dementia: barriers and facilitators

Public Health England commissioned the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science to conduct a study of primary prevention of dementia. The study included a literature review of midlife risk factors for dementia and a study of barriers and facilitators to primary prevention. This report presents the findings of the study concerned with barriers and facilitators. The literature review of midlife risk factors for dementia is published separately. To promote primary prevention of dementia it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention. Primary prevention of dementia is taken here to mean activities or measures pursued before any symptoms of dementia are manifest and, in principle, before even the asymptomatic stage. It may involve promotion and adoption of a whole system approach to healthier lifestyle (for instance, increased physical activity, smoking cessation and social engagement). It may be targeted to specific population groups or risk categories or be universal. Primary prevention is designed to reduce the risk of onset of dementia and thus to reduce the number of new cases. PSSRU conducted a focused literature review on barriers and facilitators to primary prevention of dementia in England. It conducted an internet search to identify examples of schemes organised by English local authorities, clinical commissioning groups (CCGs) or other agencies where a core aim is the primary prevention of dementia. It also consulted commissioners and other experts through a range of events and one-toone discussions. The research team found evidence or received comments on the following barriers to implementation of measures to promote primary prevention of dementia...