Voices from the Field: Chilean Health Professionals’ Practices and Perspectives on Dementia Risk Reduction in People with Memory Concerns

The Chilean national dementia plan prioritises prevention. People with Mild Cognitive Impairment (MCI) and subjective cognitive complaints (SCCs) are at increased dementia risk and may benefit from secondary prevention programmes addressing modifiable risk factors. We aimed to explore how Chilean health and social care professionals support older people with these conditions, and where they perceive gaps in current secondary dementia prevention activities. We co-designed an online mixed-methods survey responding to our aims and then purposively recruited health and care professionals working with people with cognitive concerns from diverse roles and geographical regions across Chile to complete it. We mapped findings to the Consolidated Framework for Implementation Research, identifying meta-inferences in a convergent analysis. A total of 110 professionals (31.8% women) completed the survey. Of those providing diagnostic services, half frequently diagnosed patients with MCI (42.4%, n = 25/59) or SCCs (54.2%, n = 32/59) at least once a week. In the overall sample, most professionals were likely to explain that MCI increased dementia risk (79.1%, n = 87/110), and around half did so for SCCs (54.5%, n = 60/110). Some were more likely to discuss risk reduction if they perceived patients as capable, resourceful and motivated to make lifestyle changes. Meta-inferences highlighted that successful secondary risk reduction requires multimodal, flexible, evidence-based design, adequate physical infrastructure, suitably trained staff, funding, and a wider consideration of socioeconomic and health inequalities. Current professional practice in delivering dementia prevention advice may unintentionally reinforce inequalities. National prevention strategies should address structural inequalities to reach those most likely to benefit. People with memory concerns are a heterogenous group; framing their management as dementia prevention may not be appropriate for all cases.