Midlife dementia risk and later dementia-related fear and avoidance: evidence from a prospective cohort study

OBJECTIVES: Dementia-related fear can influence help-seeking and engagement with prevention, yet it is unclear whether these responses vary with objectively measured dementia risk in midlife. We tested whether midlife risk was associated with subsequent dementia-related fear and avoidance. METHODS: Participants were 197 cognitively healthy adults from the PREVENT cohort (ages 40-59). Midlife dementia risk was assessed using CAIDE and LIBRA scores. Dementia-related fear and avoidance were measured approximately 4.2 years later using the Fear-Avoidance of Memory Loss scale. Regression models tested associations between midlife risk and later fear and avoidance, adjusting for covariates; component-level associations were also examined. RESULTS: Higher midlife risk was associated with greater fear and avoidance, with associations that were more consistent and pronounced for LIBRA. Depressive symptoms and diet showed the largest component-level associations. CONCLUSION: Emotional and behavioral responses to dementia risk are evident in midlife, highlighting their potential relevance for mental health-informed communication and prevention strategies.