family member with alzheimer’s disease across five countries

7/29/2019 Family Member with Alzheimers Disease across Five Countries

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Hindawi Publishing CorporationInternational Journal of Alzheimers DiseaseVolume 2012, Article ID 903645, 9 pagesdoi:10.1155/2012/903645

Research ArticleThe Impact of Experience with a Family Member with AlzheimersDisease on Views about the Disease across Five Countries

Robert J. Blendon,1 John M. Benson,1 Elizabeth M. Wikler,2 Kathleen J. Weldon,1

Jean Georges,3 Matthew Baumgart,4 and Beth A. Kallmyer5

1 Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA2 Program in Health Policy, Harvard University, Cambridge, MA 02138, USA3Alzheimer Europe, 145 Route de Thionville, 2611 Luxembourg, Luxembourg

4 Government Affairs, Alzheimers Association, Washington, DC 20005, USA5 Constituent Services, Alzheimers Association, Chicago, IL 60613, USA

Correspondence should be addressed to John M. Benson, [email protected]

Received 27 April 2012; Accepted 13 July 2012

Academic Editor: Ricardo Nitrini

Copyright 2012 Robert J. Blendon et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.

The objective of this paper is to understand how the publics beliefs in five countries may change as more families have directexperience with Alzheimers disease. The data are derived from a questionnaire survey conducted by telephone (landline and cell)with 2678 randomly selected adults in France, Germany, Poland, Spain, and the United States. The paper analyzes the beliefs andanticipated behavior of those in each country who report having had a family member with Alzheimers disease versus those whodo not. In one or more countries, differences were found between the two groups in their concern about getting Alzheimersdisease, knowledge that the disease is fatal, awareness of certain symptoms, and support for increased public spending. The resultssuggest that as more people have experience with a family member who has Alzheimers disease, the public will generally becomemore concerned about Alzheimers disease and more likely to recognize that Alzheimers disease is a fatal disease. The findingssuggest that other beliefs may only be affected if there are future major educational campaigns about the disease. The publicsin individual countries, with differing cultures and health systems, are likely to respond in different ways as more families haveexperience with Alzheimers disease.

1. Introduction

Prevalence rates for Alzheimers disease in Europe and theUnited States are estimated as some of the highest in theworld, growing rapidly with the aging demographic shift[14]. Alzheimers disease is one of the leading causes ofdeath in these countries, and the costs imposed by it aresubstantial in terms of caregiving demands, lost productivity,and strains on health care systems [5]. Among scientists,health professionals, and policymakers, interest in the diseasehas grown in recent years due to the growing demandsfor care by patients and a number of important researchfindings, including the identification of additional geneticrisk factors and the release of new diagnostic guidelines

[6, 7]. This complements other recent scientific develop-

ments in potential drug therapies, diagnostic procedures [8],and other research on potential risk factors, such as dietarychoices, chronic disease, and medication usage [9, 10].

Single-country surveys have looked at public attitudesand beliefs about Alzheimers disease [11, 12]. However, littleis known about how levels of awareness and beliefs varyacross Europe and the United States, with their differentcultures and health systems. To fill this information void,Alzheimer Europe and the Harvard School of Public Healthconducted a five-country international poll to assess publicunderstanding about Alzheimers disease [13, 14]. The pollinvolved random samples of the public in France, Germany,Poland, Spain, and the US. It is important to look at attitudes


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2 International Journal of Alzheimers Disease

Table 1

Interview dates Total interviews Margin of error (percentage points)

France February 714, 2011 529 4.3

Germany February 719, 2011 499 4.4

Poland February 710, 2011 509 4.3

Spain February 813, 2011 502 4.4

US February 727, 2011 639 3.9

and beliefs across countries because results from a singlecountry may not be generalizable to other countries that havedifferent values and experiences with Alzheimers disease.

The multicountry poll focused primarily on eight broadissues. These included (1) the relative public concern aboutthe disease when compared to other serious national healthproblems, (2) the publics willingness to see a physician toobtain a diagnosis if they were exhibiting symptoms possiblyassociated with the disease, (3) public beliefs about whetheran effective treatment to slow the progression of the diseasewas currently available, (4) public beliefs about whether areliable test was currently available that will determine if aperson who is suffering from some confusion and memoryloss is in the early stages of Alzheimers disease, (5) thepublics interest in future early diagnostic testing for thedisease, should such a test become available, (6) public beliefsabout whether Alzheimers disease is a fatal disease, (7) thelevel of public awareness of common symptoms that wereassociated with the disease, and (8) public attitudes aboutgovernment spending on Alzheimers research and care.

The focus of this paper is an analysis of the beliefs andanticipated behavior of those in each country who reportthat they have had a family member with Alzheimers disease

versus those who say they have not. If the experience of hav-ing a family member with Alzheimers disease affects beliefsand behaviors, overall public attitudes and understandingof the disease might be expected to change as the numberof people with experience grows as a result of anticipateddemographic shifts. Therefore, understanding the differencesin perspective between those who have had a family memberwith the disease and those who have not is important inpredicting possible changes in public beliefs and behaviorsin each country. We present the major findings of thefive-country poll in this comparative context and suggestimplications of the possible changes in public response in theyears ahead.

2. Methods

2.1. Source of Data. The data are derived from a February2011 survey by Alzheimer Europe and the Harvard School ofPublic Health with nationally representative random samplesof adults age 18 and older in France, Germany, Poland, Spain,and the United States [13].

2.2. Study Design. In each of the five countries, interviewswere conducted of both landline telephone numbers usingrandom-digit dialing and cell phone numbers using a list

of random cell phone numbers across the country amongadults age 18 and older. The average length of interview was12 minutes. Table 1 shows interview dates, samples sizes, andmargins of error at the 95% confidence level for each country.

The fieldwork was conducted for Alzheimer Europe andthe Harvard School of Public Health by TNS, an independentresearch company based in London, with branches in eachof the five countries surveyed. TNS is one of the largestsurvey research companies internationally and also currentlyconducts the Eurobarometer surveys of adults in EuropeanUnion countries for the European Commission.

The interviews were conducted in the language of eachcountry. In the US, interviews were conducted in bothEnglish and Spanish.

2.3. Poststratification Weighting. Nonresponse in telephonesurveys produces some known biases in survey-derivedestimates because participation tends to vary for differentsubgroups of the population. To compensate for theseknown biases, the sample data are weighted to reflect theactual composition of the adult population in the surveyedcountries, calculated on the basis of census data from each

country, according to race/ethnicity (US only), age, gender,and region. The sample data are also weighted by telephonestatus (landline, cell). Other techniques, such as callbacksstaggered over times of days and days of weeks and systematicrespondent selection within households, are used to helpensure that the sample in each country is representative.

The data presented in this paper are weighted percent-ages. After weighting, the sample for each country reflectsthe demographic composition of the adult population ofthat country as presented in its census. The results for eachcountry are generalizable to the adult population of thatcountry.

2.4. Statistical Analysis. Data analysis comprises descriptivestatistics to ascertain public attitudes on each of the mea-sures. Percentages and confidence intervals (at the 95%confidence level) are shown for the responses to each surveyitem of those who report that they have had a family memberwith Alzheimers disease versus those who say they have notin each country.

The survey found that the publics reported experiencewith a family member with Alzheimers disease variedsubstantially across the fivecountries. The proportion rangedfrom 19% in Poland to 30% in France, 33% in Spain, 34% inGermany, and 42% in the US.


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International Journal of Alzheimers Disease 3

Table 2 presents comparative data for those with andwithout experience for the first six issues discussed above.Table 3 shows comparative data between these two groupson public perceptions of common symptoms associatedwith Alzheimers disease. Table 4 presents comparative databetween these two groups on attitudes about government

spending related to Alzheimers disease. We highlight onlythose differences within each country that are statisticallysignificant (P < 0.05).

2.5. Limitations. The poll could not identify whethernational differences in the proportion of respondents report-ing family experience with Alzheimers disease were related tovariation in the incidence of the disease, cultural or historicalfactors that might influence the use of Alzheimers disease asa diagnostic term, or differences in public education aboutthe disease in individual countries that might play a role inawareness of the disease.

Those with family experience with Alzheimers disease

may have received educational support during this experi-ence, which may affect differences in awareness between theexperienced and nonexperienced groups.

3. Results

3.1. Relative Public Concern about Alzheimers Disease WhenCompared to Other Serious National Health Problems.Alzheimers disease is ranked as a major concern in manycountries. In three of the countries, Germany, Poland, andthe US, those with personal family experience were morelikely than those without experience to choose Alzheimersdisease as the disease they were most afraid of getting.

Experience did not significantly aff

ect views in France andSpain (Table 2).

3.2. Willingness to See a Physician to Obtain a DiagnosisIf They Were Exhibiting Symptoms Possibly Associated withthe Disease. Most report that they would see a doctor fordiagnosis if they had symptoms. There were no differencesin any country in those who would seek a physicianassessment with signs of possible Alzheimers disease basedon experience with having a family member who had thedisease.

3.3. Beliefs about Whether an Effective Treatment to Slow

the Progression of the Disease Was Currently Available. Manybelieve an effective treatment to slow the progression of thedisease and make symptoms less severe is currently available.In all five countries, experience with a family member didnot lead to different beliefs about the current availability ofan effective treatment.

3.4. Beliefs about Whether a Reliable Test Was CurrentlyAvailable That Will Determine If a Person Who Is Sufferingfrom Some Confusion and Memory Loss Is in the Early Stages ofAlzheimers Disease. A substantial portion of the public in allfive countries believes a reliable test is available to determineif a person suffering from confusion and memory loss is in

the early stages of Alzheimers disease. Only in one countrydid experience with a family member alter beliefs about thecurrent availability of a reliable test. Belief increased from44% with no family experience to 56% among those withdirect experience in Spain. In all other countries, there wasno significant difference between the two groups.

3.5. Interest in Future Early Diagnostic Testing for the Disease,Should Such a Test Become Available. There is substantialpublic interest in early diagnostic testing. There was nodifference in any country based on personal experience witha family member in the proportion that said they were verylikely to take a diagnostic test without symptoms.

3.6. Beliefs about Whether Alzheimer Is a Fatal Disease.Large numbers do not believe Alzheimer is a fatal disease.Experience with a family member increased the belief thatAlzheimer was a fatal disease in three countriesFrance,Poland, and Spain. It did not in Germany and the US.

3.7. Awareness of Common Symptoms That Were Associatedwith Alzheimers Disease. There is general agreement onsome symptoms of Alzheimers disease, disagreement onothers. As shown in Table 3, experience with a familymember does not change perceptions of most symptomsacross countries. Experience with Alzheimers disease hadno impact on beliefs about three symptomshallucinations,problems with pain, and difficulty managing and payingbills.

In three or more countries, experience with a familymember affected beliefs about confusion and disorientation,

diffi

culty managing daily tasks, and anger and violence.In each of these cases, experience with a family memberincreased the belief that these were common symptoms ofthe disease. In Poland, beliefs about two other symptomswere affected by family experience with the disease. Thosewho had experience with a family member were more likelythan those without experience to believe wandering andgetting lost was a common symptom. On the other hand,those who had experience with a family member were lesslikely than those without experience to believe that difficultyremembering things in their life from years before was acommon symptom.

In the US, the belief that difficulty remembering thingsin their life from the day before was a common symptom wasincreased by experience with a family member.

3.8. Attitudes about Government Spending on AlzheimersResearch and Care. As shown in Table 4, majorities of thepublic in all five countries favor increased governmentspending on research on new treatments for Alzheimersdisease and on caring for people who have the disease.In two countriesGermany and Polandthose who hadexperience with a family member were more likely than thosewithout family experience to favor increased governmentspending on research on new treatments. Only in Poland,those with family experience were also more likely to favor


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Table2:AttitudesandbeliefsaboutAlzheimersdisease,byexperiencewitha

familymember.

Attitudeorbelief

Country(unweightedn

fortotal

sample;thosewhohavehadafamily

memberwithAD;thosewhohavenot)

Total

%(CI95%)

Yes,haveeverhad

familymember

withAD

%(CI95%)

No,havenot

%(CI95%)

P

value(family

memberversusno

familymember)

ChooseAlzheimersdiseasefromlistof

sevendiseasesastheonetheyaremost

afraidofgetting

France(n=

529;166;363)

27(2331)

30(2237)

26(2131)

0.428

Germany(n=

499;177;317)

23(1927)

31(2338)

19(1424)

0.015

Poland(n=

509;92;410)

12(915)

24(1533)

9(613)

0.004

Spain(n=

502;172;328)

24(2028)

29(2136)

21(1626)

0.082

US(n=

639;257;379)

22(1825)

27(2133)

18(1422)

0.014

Ifexhibitingconfusionandmemory

loss,youwouldgotoadoctorto

determineifcausewasAlzheimers

disease

France(n=

529;166;363)

88(8591)

92(8797)

87(8391)

0.116

Germany(n=

499;177;317)

90(8793)

89(8494)

91(8794)

0.637

Poland(n=

509;92;410)

85(8289)

89(8296)

85(8089)

0.271

Spain(n=

502;172;328)

95(9398)

93(8897)

97(9599)

0.126

US(n=

639;257;379)

89(8692)

86(8191)

91(8894)

0.106

Believeaneffectivetreatmentcurrently

availabletoslowtheprogressionofthe

diseaseandmakesymptomslesssevere

France(n=

529;166;363)

40(3544)

45(3753)

38(3343)

0.183

Germany(n=

499;177;317)

42(3747)

45(3753)

40(3446)

0.360

Poland(n=

509;92;410)

63(5867)

64(5375)

63(5768)

0.826

Spain(n=

502;172;328)

27(2331)

29(2236)

26(2131)

0.510

US(n=

639;257;379)

46(4251)

48(4154)

46(4051)

0.699

Believereliabletestcurrentlyavailable

todetermineifapersonsufferingfrom

confusionandmemorylossisinthe

earlystagesofAlzheimersdisease

France(n=

529;166;363)

50(4655)

52(4460)

49(4455)

0.636

Germany(n=

499;177;317)

43(3948)

48(3956)

41(3547)

0.216

Poland(n=

509;92;410)

38(3443)

33(2344)

40(3445)

0.291

Spain(n=

502;172;328)

48(4353)

56(4865)

44(3850)

0.014

US(n=

639;257;379)

59(5563)

59(5265)

60(5465)

0.840

Verylikelytogetdiagnostictestif,in

thefuture,onebecameavailablethat

wouldtellpeoplebeforetheyhad

symptomswhethertheywillget

Alzheimersdisease


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Table2:Continued.

Attitudeorbelief

Country(unweightedn

fortotal



Total

%(CI95%)

Yes,haveeverhad

familymember

withAD

%(CI95%)

No,havenot

%(CI95%)

P

value(family

memberversusno

familymember)

France(n=

529;166;363)

26(2230)

27(2034)

26(2131)

0.838

Germany(n=

499;177;317)

23(1927)

28(2136)

21(1626)

0.090

Poland(n=

509;92;410)

30(2534)

35(2546)

28(2333)

0.227

Spain(n=

502;172;328)

39(3443)

43(3552)

36(3042)

0.159

US(n=

639;257;379)

29(2633)

31(2538)

28(2333)

0.420

BelieveAlzheimersisafataldisease

France(n=

529;166;363)

44(4049)

53(4461)

41(3647)

0.023

Germany(n=

499;177;317)

33(2837)

35(2743)

31(2637)

0.477

Poland(n=

509;92;410)

34(3039)

45(3356)

32(2737)

0.046

Spain(n=

502;172;328)

42(3746)

51(4359)

37(3143)

0.007

US(n=

639;257;379)

61(5765)

60(5467)

61(5667)

0.806

Source:[13].


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Table3:Perceptionsofcommonsympto

msofAlzheimersdisease,byexperiencewithafamilymember.

Perceiveeachofthefollowingtobea

commonsymptomofAlzheimers

disease

Country(unweightedn

fortotal



Total

%(CI95%)

Yes,haveeverhad

familymemberwith

AD

%(CI95%)

No,havenot

%(CI95%)

P

value(family

memberversusno

familymember)

Hallucinationsorhearingvoices

France(n=

529;166;363)

24(2028)

23(1630)

24(1929)

0.910

Germany(n=

499;177;317)

34(2939)

34(2642)

34(2840)

0.911

Poland(n=

509;92;410)

26(2230)

34(2344)

24(2029)

0.119

Spain(n=

502;172;328)

40(3545)

44(3653)

38(3244)

0.185

US(n=

639;257;379)

40(3645)

39(3245)

42(3647)

0.459

Pain France(n=

529;166;363)

23(1927)

20(1326)

24(1929)

0.283

Germany(n=

499;177;317)

22(1726)

26(1834)

19(1425)

0.160

Poland(n=

509;92;410)

21(1725)

28(1838)

20(1624)

0.142

Spain(n=

502;172;328)

24(2028)

20(1427)

26(2031)

0.196

US(n=

639;257;379)

25(2129)

25(1930)

25(2130)

0.865

Difficultymanagingandpayingbills

France(n=

529;166;363)

80(7683)

83(7789)

79(7483)

0.297

Germany(n=

499;177;317)

73(6877)

77(7085)

71(6576)

0.152

Poland(n=

509;92;410)

73(6978)

80(7089)

72(6777)

0.160

Spain(n=

502;172;328)

80(7684)

82(7688)

79(7484)

0.434

US(n=

639;257;379)

84(8087)

85(8090)

82(7887)

0.405

Confusionanddisorientation

France(n=

529;166;363)

91(8994)

95(9299)

90(8693)

0.027

Germany(n=

499;177;317)

92(8994)

93(8997)

91(8795)

0.433

Poland(n=

509;92;410)

86(8390)

93(8798)

85(8189)

0.024

Spain(n=

502;172;328)

96(9498)

97(9599)

96(9398)

0.403

US(n=

639;257;379)

92(9094)

96(9398)

90(8693)

0.004

Difficultymanagingdailytasks

France(n=

529;166;363)

83(7986)

86(8092)

82(7786)

0.247

Germany(n=

499;177;317)

86(8389)

92(8796)

83(7988)

0.014

Poland(n=

509;92;410)

85(8188)

93(8898)

83(7987)

0.002

Spain(n=

502;172;328)

88(8491)

91(8696)

86(8290)

0.171

US(n=

639;257;379)

88(8591)

92(8896)

85(8189)

0.015

Angerandviolence

France(n=

529;166;363)

46(4251)

55(4763)

42(3748)

0.013

Germany(n=

499;177;317)

40(3545)

47(3855)

37(3143)

0.061

Poland(n=

509;92;410)

35(3140)

49(3360)

32(2237)

0.010

Spain(n=

502;172;328)

48(4353)

56(4865)

44(3850)

0.023

US(n=

639;257;379)

53(4958)

59(5266)

49(4455)

0.030


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Table3:Continued.

Perceiveeachofthefollowingtobea

commonsymptomofAlzheimers

disease

Country(unweightedn

fortotal



Total

%(CI95%)

Yes,haveeverhad

familymemberwith

AD

%(CI95%)

No,havenot

%(CI95%)

P

value(family

memberversusno

familymember)

Wanderingandgettinglost

France(n=

529;166;363)

92(9095)

95(9299)

91(8894)

0.072

Germany(n=

499;177;317)

89(8592)

91(8796)

87(8392)

0.205

Poland(n=

509;92;410)

88(8491)

94(8699)

86(8290)

0.018

Spain(n=

502;172;328)

95(9397)

97(9499)

94(9197)

0.197

US(n=

639;257;379)

91(8994)

92(8995)

91(8794)

0.555

Difficultyrememberingthingsintheir

lifefromyearsbefore

France(n=

529;166;363)

47(4251)

44(3652)

48(4354)

0.405

Germany(n=

499;177;317)

44(3949)

47(3855)

43(3749)

0.450

Poland(n=

509;92;410)

58(5463)

48(3659)

61(5666)

0.039

Spain(n=

502;172;328)

76(7280)

70(6378)

79(7484)

0.056

US(n=

639;257;379)

68(6471)

64(5770)

70(6575)

0.120

Difficultyrememberingthingsintheir

lifefromthedaybefore

France(n=

529;166;363)

94(9296)

94(8998)

94(9297)

0.804

Germany(n=

499;177;317)

87(8490)

89(8494)

86(8290)

0.411

Poland(n=

509;92;410)

80(7684)

85(7893)

79(7584)

0.179

Spain(n=

502;172;328)

91(8894)

91(8796)

91(8795)

0.955

US(n=

639;257;379)

91(8994)

95(9297)

89(8693)

0.020

Source:[13].


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Table 4: Attitudes about government spending on Alzheimers research and care, by experience with a family member.

Attitude about spendingCountry (unweighted n for totalsample; those who have had afamily member with AD; thosewho have not)

Total% (CI 95%)

Yes, have ever hadfamily member with

AD% (CI 95%)

No, have not% (CI 95%)

P value (familymember versus no

family member)

Favor increased governmentspending on research on newtreatments for Alzheimersdisease

France (n = 529; 166; 363) 83 (7986) 84 (7891) 82 (7786) 0.497

Germany (n = 499; 177; 317) 68 (6373) 75 (6883) 65 (5971) 0.032

Poland (n = 509; 92; 410) 75 (7079) 85 (7694) 72 (6777) 0.013

Spain (n = 502; 172; 328) 83 (7987) 87 (8193) 82 (7786) 0.212

US (n = 639; 257; 379) 67 (6371) 66 (6073) 68 (6273) 0.758

Favor increased governmentspending on caring for peoplewith Alzheimers disease

France (n = 529; 166; 363) 85 (8188) 83 (7790) 85 (8189) 0.599

Germany (n = 499; 177; 317) 69 (6473) 73 (6581) 67 (6173) 0.288

Poland (n = 509; 92; 410) 71 (6776) 86 (7794) 68 (6373) 0.006

Spain (n = 502; 172; 328) 79 (7583) 82 (7689) 77 (7182) 0.187

US (n = 639; 257; 379) 60 (5664) 64 (5770) 57 (5163) 0.129

Source: [13].

increased spending on caring for people with Alzheimersdisease.

4. DiscussionObviously, many things could change in the coming years. Asingle reliable test or a new, effective form of treatment couldbe found, or certain lifestyle changes could be scientificallyrecognized as being effective. But in the absence of suchdevelopments, one would expect certain changes of attitudeand belief to occur as more people have experience witha family member who has Alzheimers disease. The resultssuggest that, in general, the public will become moreconcerned about Alzheimers disease and more likely torecognize that Alzheimer is a fatal disease, although mostbeliefs about the disease are unlikely to change.

One of the rationales for this study is that the publics

in individual countries, with differing cultures and healthsystems, are likely to respond in different ways as morefamilies have experience with Alzheimers disease. What dothe survey findings mean for the future in each of the fivecountries?

For France, we would expect that as the number ofpeople who have experience with a family member who hasAlzheimers disease grows, changes in public attitudes andbeliefs would change in three areas. A larger proportion ofthe French public would believe that Alzheimer is a fataldisease. In addition, more would perceive anger and violenceand confusion and disorientation to be common symptomsof the disease.

For Germany, as the proportion of those who have familyexperience with Alzheimers disease grows, we would expectchanges in three areas. A larger proportion of the Germanpublic would choose Alzheimer as the disease they are mostafraid of getting. In addition, more would perceive that

difficulty managing daily tasks is to be a common symptomof the disease. A larger proportion would also favor increaseof government spending on new treatments for the disease.

Poland starts out as the country with the smallestproportion of the population reporting family experiencewith Alzheimers disease among the five countries in thesurvey. As that proportion grows in the future, we wouldexpect changes in public attitudes and beliefs in nine areas.A larger proportion of the Polish public would chooseAlzheimer as the disease they are most afraid of getting,believe that Alzheimer is a fatal disease, and perceive thefollowing to be common symptoms of the disease: confusionand disorientation, difficulty managing daily tasks, anger

and violence, and wandering and getting lost. If the patternpersists, one would also expect a smaller proportion toperceive difficulty remembering things from their life fromyears before to be a common symptom. In addition, a largerproportion would be expected to favor increased governmentspending on research on new treatments for Alzheimersdisease and on caring for people who have the disease.

For Spain, as the proportion of those who have familyexperience with Alzheimers disease grows, we would expectchanges in public attitudes and beliefs in three areas. Alarger proportion of the Spanish public would believe thata reliable test is available to determine if a person sufferingfrom confusion and memory loss is in the early stages of


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Alzheimers disease, believe that Alzheimer is a fatal disease,and perceive anger and confusion to be a common symptomof the disease.

The United States starts out as the country with thelargest proportion of the population reporting family expe-rience with Alzheimers disease among the five countries in

the survey. As that proportion grows in the future, we wouldexpect changes in public attitudes and beliefs in five areas. Alarger proportion of the US public would choose Alzheimeras the disease they are most afraid of getting and perceive thefollowing to be common symptoms of the disease: confusionand disorientation, difficulty managing daily tasks, anger andviolence, and difficulty remembering things in their life fromthe day before.

Looking across the five countries, the growing propor-tion of people who have family experience with Alzheimersdisease is likely to have its greatest impact in Poland.Overall, however, the survey results indicate that most of thepublics attitudes and beliefs about Alzheimer in these fivecountries may not be affected by wider family experiencewith the disease. These findings show the importance ofmajor educational campaigns about Alzheimers disease, itsdiagnosis, treatment, and symptoms. In the absence of sucheducational efforts, many public attitudes and beliefs areunlikely to change significantly in the future. In addition,without such an educational campaign, some beliefs that arefactually incorrect are likely to remain in the publics mind.

These findings are important to each country becausethey show the possibilities of what widespread educationalcampaigns could do. Improved public education may con-tribute to a reduction of personal and social burden invarious, for example, helping people plan for the future. Theresults also suggest that educational campaigns could havea different focus in each country depending on the currentlevel of knowledge, awareness, and beliefs.

With Alzheimers disease and other forms of dementiabecoming a growing global problem [15], these findings sug-gest that conducting surveys of the public in other countriescould provide useful information for health professionalsand policy makers dealing with Alzheimers disease and otherforms of dementia in their own country in the future.

Acknowledgment

The survey was supported by a grant to Alzheimer Europefrom Bayer AG. Bayer was not involved in the design of thesurvey, the data collection, the analysis or interpretation ofthe findings, or the preparation of the paper.

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family member with alzheimer’s disease across five countries

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