Exploring English policymakers' attitudes towards dementia risk reduction: A qualitative study

AimA growing evidence-base indicates that dementia occurrence can be changed. This has been linked to potentially modifiable risk factors. Risk reduction and primary prevention strategies are increasingly recognized as needing to include population-level policies to tackle the social and commercial determinants of health. How this knowledge can influence policymaking on dementia prevention is unknown. Understanding attitudes of policymakers is an important step in translating evidence into practice, helping to gauge system readiness for implementation, and potential barriers and enablers for influencing policy. The aim of this qualitative study is to explore the understanding of, and attitudes to, dementia risk reduction and population-level prevention strategies amongst English policymakers at national, regional, and local level.MethodsSemi-structured interviews were undertaken with a range of dementia and prevention policymakers, with purposive sampling of national and local policymakers, including politicians, government officials, health system leaders, academics, and dementia charity directors. Analysis of interview transcripts was undertaken by thematic analysis.Results14 policymakers were interviewed between November 2021 and February 2022. Three main themes were identified (1) Preventability of dementia, (2) Prevention approach, (3) Barriers and facilitators to improving the approach.DiscussionPolicymakers generally held dementia to be partially preventable. Policymakers recognised that both individual- and population-level approaches to primary prevention of dementia are required - with some policymakers perceiving that population-level approaches are under-utilised. Key barriers to implementing more population-level approaches were identified as the complexity and co-ordination required to effectively tackle upstream determinants of health. Adoption of policies to address the upstream, social and commercial determinants of brain health are required to significantly reduce the prevalence of dementia and reduce inequalities, but these policies can only be implemented by coordinated action between various policymakers.We interviewed 14 policymakers related to national and local prevention policy and dementia policy.Policymakers generally held dementia to be preventable, and suggested the need for both individual-level and population-level interventions.Further work is needed to equip policymakers with the knowledge, resources, and structures required to successfully implement more population-level dementia risk reduction policies.