U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle

Jasper R Senff; Mark Jun Shah-Ostrowski; Reinier W P Tack; Courtney Nunley; Caroline R Palys; Sharon Ng; Akashleena Mallick; Leidys Gutierrez-Martinez; Jonathan Duskin; Tamara N Kimball; Savvina Prapiadou; Sandro Marini; Evy Reinders; Katelin Sherman; Ayneisha Tinoble; H Bart Brouwers; Setareh Akhavan; Amytis Towfighi; Cyprien A Rivier; Guido J Falcone; Kevin Sheth; Ronald M Lazar; Sarah Ibrahim; Aleksandra Pikula; Zeina Chemali; Cornelia van Duijn; Gregory Fricchione; Rudolph E Tanzi; Nirupama Yechoor; Christopher D Anderson; Valerie Purdie Greenaway; Koen B Pouwels; Jonathan Rosand; Sanjula Dhillon Singh

doi:10.1186/s12889-025-25077-x

U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle

Jasper R Senff
, Mark Jun Shah-Ostrowski
, Reinier W P Tack
, Courtney Nunley
, Caroline R Palys
, Sharon Ng
, Akashleena Mallick
, Leidys Gutierrez-Martinez
, Jonathan Duskin
, Tamara N Kimball
, Savvina Prapiadou
, Sandro Marini
, Evy Reinders
, Katelin Sherman
, Ayneisha Tinoble
, H Bart Brouwers
, Setareh Akhavan
, Amytis Towfighi
, Cyprien A Rivier
, Guido J Falcone

Kevin Sheth, Ronald M Lazar, Sarah Ibrahim, Aleksandra Pikula, Zeina Chemali, Cornelia van Duijn, Gregory Fricchione, Rudolph E Tanzi, Nirupama Yechoor, Christopher D Anderson, Valerie Purdie Greenaway, Koen B Pouwels, Jonathan Rosand, Sanjula Dhillon Singh^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Epidemiological studies suggest that approximately 40% of dementia and 60% of stroke cases could be prevented through adequate control of modifiable risk factors. Limited data are available on the public perceptions in the United States (U.S.) on whether the risk of dementia and stroke can be modified through lifestyle changes.

METHODS: A survey utilizing questions from validated questionnaires was distributed to a sample of the general U.S.

POPULATION: We performed multivariable logistic regression analyses for which the binary exposure was ever having known someone with dementia or stroke, and the primary outcomes were the perceptions on whether dementia and stroke risk could be modified through maintaining or changing lifestyle.

RESULTS: We included 1,478 participants (mean [SD] age: 45.5 [15.9], 51.1% female), of whom 80% (N = 1185) ever knew someone with dementia or stroke. Over 75% of all participants perceived that a healthy lifestyle can lower dementia and stroke risks. Following multivariable analyses, participants who ever knew someone with dementia or stroke were more likely to agree that maintaining (adjusted Odds Ratio [aOR] = 1.41, 95%CI:1. 10-1.96) and that changing lifestyle (aOR = 1.59, 95%CI:1.14-2.24) reduces dementia risk, when adjusted for age, sex assigned at birth, race/ethnicity, level of education, employment status, and being a caregiver for someone with dementia or stroke. Participants who knew someone with dementia or stroke were also more likely to agree that maintaining (aOR = 1.77, 95%CI:1.27-2.47) or changing lifestyle (aOR = 2.31, 95%CI:1.41-3.76) reduces stroke risk when adjusted for similar confounders.

DISCUSSION: This cross-sectional cohort, mimicking the general U.S. population, demonstrated that over 80% of individuals ever knew someone with dementia or stroke and that this was positively associated with the perceptions that dementia and stroke risk could be modified through lifestyle changes. The widespread exposure of the U.S. public to dementia and stroke first-hand can be leveraged into more effective preventive strategies.

Original language	English
Article number	4191
Journal	BMC Public Health
Volume	25
Issue number	1
DOIs	https://doi.org/10.1186/s12889-025-25077-x
Publication status	Published - 28 Nov 2025

Keywords

Adult
Aged
Dementia/prevention & control
Female
Health Knowledge, Attitudes, Practice
Humans
Life Style
Male
Middle Aged
Public Opinion
Risk Factors
Risk Reduction Behavior
Stroke/prevention & control
Surveys and Questionnaires
United States/epidemiology

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U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyleFinal published version, 1.48 MBLicence: CC BY

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Senff, J. R., Shah-Ostrowski, M. J., Tack, R. W. P., Nunley, C., Palys, C. R., Ng, S., Mallick, A., Gutierrez-Martinez, L., Duskin, J., Kimball, T. N., Prapiadou, S., Marini, S., Reinders, E., Sherman, K., Tinoble, A., Brouwers, H. B., Akhavan, S., Towfighi, A., Rivier, C. A., ... Singh, S. D. (2025). U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle. BMC Public Health, 25(1), Article 4191. https://doi.org/10.1186/s12889-025-25077-x

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title = "U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle",

abstract = "BACKGROUND: Epidemiological studies suggest that approximately 40\% of dementia and 60\% of stroke cases could be prevented through adequate control of modifiable risk factors. Limited data are available on the public perceptions in the United States (U.S.) on whether the risk of dementia and stroke can be modified through lifestyle changes.METHODS: A survey utilizing questions from validated questionnaires was distributed to a sample of the general U.S.POPULATION: We performed multivariable logistic regression analyses for which the binary exposure was ever having known someone with dementia or stroke, and the primary outcomes were the perceptions on whether dementia and stroke risk could be modified through maintaining or changing lifestyle.RESULTS: We included 1,478 participants (mean [SD] age: 45.5 [15.9], 51.1\% female), of whom 80\% (N = 1185) ever knew someone with dementia or stroke. Over 75\% of all participants perceived that a healthy lifestyle can lower dementia and stroke risks. Following multivariable analyses, participants who ever knew someone with dementia or stroke were more likely to agree that maintaining (adjusted Odds Ratio [aOR] = 1.41, 95\%CI:1. 10-1.96) and that changing lifestyle (aOR = 1.59, 95\%CI:1.14-2.24) reduces dementia risk, when adjusted for age, sex assigned at birth, race/ethnicity, level of education, employment status, and being a caregiver for someone with dementia or stroke. Participants who knew someone with dementia or stroke were also more likely to agree that maintaining (aOR = 1.77, 95\%CI:1.27-2.47) or changing lifestyle (aOR = 2.31, 95\%CI:1.41-3.76) reduces stroke risk when adjusted for similar confounders.DISCUSSION: This cross-sectional cohort, mimicking the general U.S. population, demonstrated that over 80\% of individuals ever knew someone with dementia or stroke and that this was positively associated with the perceptions that dementia and stroke risk could be modified through lifestyle changes. The widespread exposure of the U.S. public to dementia and stroke first-hand can be leveraged into more effective preventive strategies.",

keywords = "Adult, Aged, Dementia/prevention \& control, Female, Health Knowledge, Attitudes, Practice, Humans, Life Style, Male, Middle Aged, Public Opinion, Risk Factors, Risk Reduction Behavior, Stroke/prevention \& control, Surveys and Questionnaires, United States/epidemiology",

author = "Senff, \{Jasper R\} and Shah-Ostrowski, \{Mark Jun\} and Tack, \{Reinier W P\} and Courtney Nunley and Palys, \{Caroline R\} and Sharon Ng and Akashleena Mallick and Leidys Gutierrez-Martinez and Jonathan Duskin and Kimball, \{Tamara N\} and Savvina Prapiadou and Sandro Marini and Evy Reinders and Katelin Sherman and Ayneisha Tinoble and Brouwers, \{H Bart\} and Setareh Akhavan and Amytis Towfighi and Rivier, \{Cyprien A\} and Falcone, \{Guido J\} and Kevin Sheth and Lazar, \{Ronald M\} and Sarah Ibrahim and Aleksandra Pikula and Zeina Chemali and \{van Duijn\}, Cornelia and Gregory Fricchione and Tanzi, \{Rudolph E\} and Nirupama Yechoor and Anderson, \{Christopher D\} and Greenaway, \{Valerie Purdie\} and Pouwels, \{Koen B\} and Jonathan Rosand and Singh, \{Sanjula Dhillon\}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2025.",

year = "2025",

month = nov,

day = "28",

doi = "10.1186/s12889-025-25077-x",

language = "English",

volume = "25",

journal = "BMC Public Health",

issn = "1471-2458",

publisher = "BioMed Central Ltd.",

number = "1",

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Senff, JR, Shah-Ostrowski, MJ, Tack, RWP, Nunley, C, Palys, CR, Ng, S, Mallick, A, Gutierrez-Martinez, L, Duskin, J, Kimball, TN, Prapiadou, S, Marini, S, Reinders, E, Sherman, K, Tinoble, A, Brouwers, HB, Akhavan, S, Towfighi, A, Rivier, CA, Falcone, GJ, Sheth, K, Lazar, RM, Ibrahim, S, Pikula, A, Chemali, Z, van Duijn, C, Fricchione, G, Tanzi, RE, Yechoor, N, Anderson, CD, Greenaway, VP, Pouwels, KB, Rosand, J & Singh, SD 2025, 'U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle', BMC Public Health, vol. 25, no. 1, 4191. https://doi.org/10.1186/s12889-025-25077-x

TY - JOUR

T1 - U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle

AU - Senff, Jasper R

AU - Shah-Ostrowski, Mark Jun

AU - Tack, Reinier W P

AU - Nunley, Courtney

AU - Palys, Caroline R

AU - Ng, Sharon

AU - Mallick, Akashleena

AU - Gutierrez-Martinez, Leidys

AU - Duskin, Jonathan

AU - Kimball, Tamara N

AU - Prapiadou, Savvina

AU - Marini, Sandro

AU - Reinders, Evy

AU - Sherman, Katelin

AU - Tinoble, Ayneisha

AU - Brouwers, H Bart

AU - Akhavan, Setareh

AU - Towfighi, Amytis

AU - Rivier, Cyprien A

AU - Falcone, Guido J

AU - Sheth, Kevin

AU - Lazar, Ronald M

AU - Ibrahim, Sarah

AU - Pikula, Aleksandra

AU - Chemali, Zeina

AU - van Duijn, Cornelia

AU - Fricchione, Gregory

AU - Tanzi, Rudolph E

AU - Yechoor, Nirupama

AU - Anderson, Christopher D

AU - Greenaway, Valerie Purdie

AU - Pouwels, Koen B

AU - Rosand, Jonathan

AU - Singh, Sanjula Dhillon

PY - 2025/11/28

Y1 - 2025/11/28

N2 - BACKGROUND: Epidemiological studies suggest that approximately 40% of dementia and 60% of stroke cases could be prevented through adequate control of modifiable risk factors. Limited data are available on the public perceptions in the United States (U.S.) on whether the risk of dementia and stroke can be modified through lifestyle changes.METHODS: A survey utilizing questions from validated questionnaires was distributed to a sample of the general U.S.POPULATION: We performed multivariable logistic regression analyses for which the binary exposure was ever having known someone with dementia or stroke, and the primary outcomes were the perceptions on whether dementia and stroke risk could be modified through maintaining or changing lifestyle.RESULTS: We included 1,478 participants (mean [SD] age: 45.5 [15.9], 51.1% female), of whom 80% (N = 1185) ever knew someone with dementia or stroke. Over 75% of all participants perceived that a healthy lifestyle can lower dementia and stroke risks. Following multivariable analyses, participants who ever knew someone with dementia or stroke were more likely to agree that maintaining (adjusted Odds Ratio [aOR] = 1.41, 95%CI:1. 10-1.96) and that changing lifestyle (aOR = 1.59, 95%CI:1.14-2.24) reduces dementia risk, when adjusted for age, sex assigned at birth, race/ethnicity, level of education, employment status, and being a caregiver for someone with dementia or stroke. Participants who knew someone with dementia or stroke were also more likely to agree that maintaining (aOR = 1.77, 95%CI:1.27-2.47) or changing lifestyle (aOR = 2.31, 95%CI:1.41-3.76) reduces stroke risk when adjusted for similar confounders.DISCUSSION: This cross-sectional cohort, mimicking the general U.S. population, demonstrated that over 80% of individuals ever knew someone with dementia or stroke and that this was positively associated with the perceptions that dementia and stroke risk could be modified through lifestyle changes. The widespread exposure of the U.S. public to dementia and stroke first-hand can be leveraged into more effective preventive strategies.

AB - BACKGROUND: Epidemiological studies suggest that approximately 40% of dementia and 60% of stroke cases could be prevented through adequate control of modifiable risk factors. Limited data are available on the public perceptions in the United States (U.S.) on whether the risk of dementia and stroke can be modified through lifestyle changes.METHODS: A survey utilizing questions from validated questionnaires was distributed to a sample of the general U.S.POPULATION: We performed multivariable logistic regression analyses for which the binary exposure was ever having known someone with dementia or stroke, and the primary outcomes were the perceptions on whether dementia and stroke risk could be modified through maintaining or changing lifestyle.RESULTS: We included 1,478 participants (mean [SD] age: 45.5 [15.9], 51.1% female), of whom 80% (N = 1185) ever knew someone with dementia or stroke. Over 75% of all participants perceived that a healthy lifestyle can lower dementia and stroke risks. Following multivariable analyses, participants who ever knew someone with dementia or stroke were more likely to agree that maintaining (adjusted Odds Ratio [aOR] = 1.41, 95%CI:1. 10-1.96) and that changing lifestyle (aOR = 1.59, 95%CI:1.14-2.24) reduces dementia risk, when adjusted for age, sex assigned at birth, race/ethnicity, level of education, employment status, and being a caregiver for someone with dementia or stroke. Participants who knew someone with dementia or stroke were also more likely to agree that maintaining (aOR = 1.77, 95%CI:1.27-2.47) or changing lifestyle (aOR = 2.31, 95%CI:1.41-3.76) reduces stroke risk when adjusted for similar confounders.DISCUSSION: This cross-sectional cohort, mimicking the general U.S. population, demonstrated that over 80% of individuals ever knew someone with dementia or stroke and that this was positively associated with the perceptions that dementia and stroke risk could be modified through lifestyle changes. The widespread exposure of the U.S. public to dementia and stroke first-hand can be leveraged into more effective preventive strategies.

KW - Adult

KW - Aged

KW - Dementia/prevention & control

KW - Female

KW - Health Knowledge, Attitudes, Practice

KW - Humans

KW - Life Style

KW - Male

KW - Middle Aged

KW - Public Opinion

KW - Risk Factors

KW - Risk Reduction Behavior

KW - Stroke/prevention & control

KW - Surveys and Questionnaires

KW - United States/epidemiology

U2 - 10.1186/s12889-025-25077-x

DO - 10.1186/s12889-025-25077-x

M3 - Article

C2 - 41316093

SN - 1471-2458

VL - 25

JO - BMC Public Health

JF - BMC Public Health

IS - 1

M1 - 4191

ER -

U.S. public perceptions on whether risk of dementia and stroke can be modified through maintaining or changing lifestyle

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