title: Public perceptions about risk and protective factors for cognitive health and impairment: a review of the literature.
abstract: BACKGROUND
  Preventing and/or delaying cognitive impairment is a public health priority. To increase awareness of and participation in behaviors that may help maintain cognitive function or reduce risk of impairment, we need to understand public perceptions about risk and protective factors.
  
  
  METHODS
  We conducted a scoping review of studies examining the public's perceptions about risk and protective factors related to cognitive health and impairment published since the 2007 National Public Health Road Map to Maintaining Cognitive Health.
  
  
  RESULTS
  A search of five databases yielded 1,115 documents published between June 2007 and December 2013. Initial review of abstracts identified 90 potentially eligible studies. After full-article review, 30 met inclusion criteria; four additional articles identified in reference lists also met inclusion criteria. Of the 34, 16 studies addressed Alzheimer's disease (AD) specifically, 15 dementia broadly, 5 mild to moderate cognitive impairment, and 8 normal functioning, with some content overlap. Across studies, respondents reported genetics (n = 14 studies), older age (n = 8), stress (n = 7), brain/head injury (n = 6), and mental illness/brain disease (n = 6) as perceived risk factors for AD and dementia. Protective factors most commonly identified for maintaining cognitive health were intellectual/mental stimulation (n = 13), physical activity (n = 12), healthy diet (n = 10), and social/leisure activities (n = 10).
  
  
  CONCLUSIONS
  Studies identified genetics and older age as key perceived risk factors more so than behaviors such as smoking. Individuals perceived that numerous lifestyle factors (e.g. intellectual stimulation, physical activity) could protect against cognitive impairment, AD, and/or dementia. Results can inform national and international education efforts about AD and other dementias.
authors.affiliation: Department of Health Promotion,Education,and Behavior,Arnold School of Public Health,University of South Carolina,Columbia,South Carolina,USA.
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Friedman
authors.affiliation: Department of Exercise Science,Arnold School of Public Health,University of South Carolina,Columbia,South Carolina,USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Becofsky
authors.affiliation: Centers for Disease Control and Prevention,National Center for Chronic Disease Prevention and Health Promotion,Healthy Aging Program,Atlanta,Georgia,USA.
authors.forename: Lynda A
authors.initials: LA
authors.lastname: Anderson
authors.affiliation: Department of Community and Behavioral Health,Colorado School of Public Health,University of Colorado Anschutz Medical Campus,Aurora,Colorado,USA.
authors.forename: Lucinda L
authors.initials: LL
authors.lastname: Bryant
authors.affiliation: Center for Health Promotion and Disease Prevention,University of North Carolina at Chapel Hill,Chapel Hill,North Carolina,USA.
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Hunter
authors.affiliation: School of Public Health,University of California,Berkeley,California,USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Ivey
authors.affiliation: Health Promotion Research Center,University of Washington,Seattle,Washington,USA.
authors.forename: Basia
authors.initials: B
authors.lastname: Belza
authors.affiliation: Department of Psychosocial & Community Health,School of Nursing,University of Washington,Seattle,Washington,USA.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Logsdon
authors.affiliation: Department of Community and Behavioral Health,Colorado School of Public Health,University of Colorado Anschutz Medical Campus,Aurora,Colorado,USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Brannon
authors.affiliation: Center for Health in Aging,Department of Medicine,Emory University,Atlanta,Georgia,USA.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Vandenberg
authors.affiliation: Department of Biobehavioral Nursing and Health Systems,School of Nursing,University of Washington,Seattle,Washington,USA.
authors.forename: Shih-Yin
authors.initials: SY
authors.lastname: Lin
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control*; D060825:Cognitive Dysfunction / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D012307:Risk Factors
keywords: Alzheimer’s disease; cognition; dementia; protective factors; public perceptions; risk factors; scoping review