Dilemmas of early dementia screening among community-dwelling older adults: a qualitative study from the perspective of social determinants of health.

Authors

Lining Xi, Junli Wan, Qifang Liu, Jingyan Liu, Huidan Yu, Xianwu Luo

Published in

Frontiers in public health. Volume 14. Pages 1927041. Epub Sep 16, 2026.

Abstract

Dementia is one of the most urgent public health challenges globally. Early screening is indispensable for timely identification and intervention. However, early dementia screening among community-dwelling older adults remains low, and the mechanisms underlying screening barriers remain insufficiently understood.
A qualitative study involving semi-structured interviews was conducted with 23 older adults who were purposively recruited from three communities in Wuhan, China. Interviews were transcribed verbatim and analyzed using thematic analysis that combined deductive coding guided by the social determinants of health framework with inductive coding to capture themes emerging from the data.
Five themes and 12 subthemes were identified: (1) economic stability, comprising economic burden concerns and the lack of material incentives; (2) education access and quality, comprising limited disease-related knowledge, the double effect of educational level, and fixed beliefs about dementia risk; (3) social and community context, comprising perceived stigma, result-related anxiety and family concerns, and late-life values; (4) health care access and quality, comprising insufficient medical trust and service assurance, limited information accessibility, and symptom-oriented healthcare-seeking behavior; and (5) neighborhood and built environment, comprising limitations in convenience and accessibility.
Low uptake of early dementia screening among community-dwelling older adults in China reflects a system-level behavioral dilemma shaped by social determinants of health. Future screening programs should build integrated, community-embedded pathways that make screening affordable, understandable, trustworthy, connected, and convenient, thereby strengthening the acceptability, equity, and sustainability of dementia prevention and early detection.

PMID:
42818577
Bibliographic data and abstract were imported from PubMed on 01 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.