Exploring attitudes and preferences for dementia screening in Britain: contributions from carers and the general public.
BACKGROUND
Dementia is becoming one of the most important emerging public health concerns in a generation. In societal approaches to the mitigation of major disease 'burden', population screening can sometimes provide an effective approach to improving detection of disease and outcomes. However the acceptability of a systematic population screening programme for dementia, to the British public, is not known.


METHODS
A Patient and Public Involvement (PPI) event was organised to give members of the public from the East of England an opportunity to offer their perspectives and to comment on the findings of a systematic literature review looking at attitudes and preferences towards screening for dementia. The event was attended by 36 members of the public and eight national Alzheimer's Society Research Network volunteers. The morning discussion contained a presentation, which defined population screening for attendees but contained no reference to the findings of the review. In the afternoon, findings of the review were presented and a discussion on the results was facilitated. The discussions were recorded, transcribed and subjected to thematic analysis. The NVivo qualitative data software was used to facilitate this process.


RESULTS
A total of 23 key themes emerged in relation to the carer and general population. The most frequent themes which emerged were the low levels of understanding and awareness around the dementia syndrome; the acceptability and validity of any tests; costs to the National Health Service (NHS); an individual's existing health status existing health status; financial/profit motive for screening; the inability to change prognosis; and the importance and availability of support.


CONCLUSIONS
Factors such as personal beliefs, experiences and attitudes to health impact on decisions to be screened for dementia. A number of additional concerns were raised which were not previously identified in the systematic literature review. These were around the economic incentives for screening (profit motive), the provision of social support, and the economic/social impacts of screening programmes. This may reflect cultural differences in health and social care funding models between Britain and other countries where previous research was conducted.
Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK. sm987@medschl.cam.ac.uk.
Steven
S
Martin
Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK. jane.fleming@phpc.cam.ac.uk.
Jane
J
Fleming
Academic Unit of Psychiatry, University of Bristol, Bristol, UK. sarah.cullum@nhs.net.
Sarah
S
Cullum
Institute of Mental Health, University of Nottingham, Nottingham, UK. tom.dening@nottingham.ac.uk.
Tom
T
Dening
Research Department of Primary Care and Population Health, UCL Medical School, UCL, London, UK. g.rait@ucl.ac.uk.
Greta
G
Rait
Faculty of Medicine and Health Sciences, Norwich, UK Medical School, University of East Anglia, Norwich, UK. Chris.Fox@uea.ac.uk.
Chris
C
Fox
Division of Psychiatry, University College London, London, UK. c.katona@ucl.ac.uk.
Cornelius
C
Katona
Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK. cb105@medschl.cam.ac.uk.
Carol
C
Brayne
Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK. ll394@medschl.cam.ac.uk.
Louise
L
Lafortune
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003258:Consumer Behavior; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D009313:National Health Programs; D011639:Public Opinion; D012944:Social Support