Background: Against the backdrop of population aging and the accelerated development of dementia-friendly communities, public stigmatizing attitudes toward dementia have emerged as a critical barrier to the social integration of affected individuals. To date, limited empirical research in China has examined the mechanisms linking dementia knowledge, contact, and stigmatizing attitudes (perceived stigma) across different age groups within indigenous community settings. This study, conducted as part of a pilot dementia-friendly community initiative in Shanghai, seeks to investigate intergenerational differences in dementia knowledge, contact experiences, and stigmatizing attitudes, and to examine the mediating role of contact in the relationship between knowledge and stigma, thereby contributing locally grounded empirical evidence to the field. Methods: A cross-sectional survey design was employed. A total of 397 community-dwelling residents aged 18 years and older in Shanghai participated in the study. Data were collected on sociodemographic characteristics, dementia knowledge, contact experiences with individuals living with dementia, and stigmatizing attitudes. Descriptive statistics and between-group analyses were used to compare age-group differences, and a mediation model was constructed to test the associations among dementia knowledge, contact, and stigma. Results: Significant intergenerational differences were observed in dementia knowledge, contact experiences, and stigmatizing attitudes. Middle-aged adults demonstrated higher levels of knowledge and more positive contact intentions; older adults reported the highest frequency of contact and the lowest levels of stigma; and younger adults exhibited the most pronounced stigmatizing attitudes. Mediation analysis further revealed that contact experience partially mediated the relationship between dementia knowledge and stigmatizing attitudes, suggesting that higher levels of dementia knowledge may be associated with reduced stigma through the facilitation of positive contact. Conclusion: Enhancing public knowledge of dementia and promoting positive contact with affected individuals may contribute to reducing social stigma and supporting the social inclusion of people living with dementia. This study further elucidates the pathway linking dementia knowledge and stigmatizing attitudes, identifying contact behavior as a significant mediator. The findings lend support to intervention strategies that integrate cognitive enhancement with structured contact initiatives, and provide preliminary evidence for age-specific community-based anti-stigma practices. It should be noted that the mediation pathway identified in this study is correlational rather than causal; moreover, as the sample was drawn from pilot dementia-friendly communities in Shanghai, the generalizability of the findings to other communities or regions may be constrained by variations in local support systems, public awareness, and aging profiles. Future research should adopt longitudinal or interventional designs to validate these findings across broader populations. Keywords: dementia, stigma, public attitudes, dementia knowledge, intergenerational difference
Li et al. (Sun,) studied this question.