Factors associated with a healthy diet and willingness to change dietary behavior in older adults at increased risk of dementia

J Alzheimers Dis. 2025 May;105(2):634-645. doi: 10.1177/13872877251330296. Epub 2025 Apr 15.

Abstract

BackgroundHealthy dietary patterns have been linked to reduced risks for cardiovascular diseases and dementia, making nutrition an essential part of a comprehensive approach for dementia prevention. Knowledge about factors associated with a healthy diet in people with increased dementia risk is scarce.ObjectiveTo analyze dietary habits and associated factors in older adults with increased dementia risk in Germany.MethodsWe used baseline-data of the AgeWell.de-trial (n = 1001, %female = 52.2, Mage = 69.0, SD = 4.9). Nutrition was assessed using a composite score, comprising 11 components covered by national recommendations for a healthy diet (range = 0-11 points). Linear regressions assessed associations of sociodemographic, social, health-related and psychological factors with consumption of a healthy diet. Further, we assessed stages of change based on the transtheoretical model of behavior change.ResultsConsumption of a healthy diet was moderate (Median = 4, IQR = 2). Female sex (b = 0.64, 95% CI: 0.41, 0.88), higher levels of motivation for healthy eating (b = 0.22, 95% CI: 0.10, 0.34) and higher self-efficacy (b = 0.33, 95% CI: 0.20, 0.46) were linked to a healthy diet. Regarding the stages of behavior change, the majority were in the maintenance stage (45.2%), followed by the contemplation (21.5%) and precontemplation (21.2%) stages.ConclusionsResults suggest room for improvement regarding a healthy diet in our sample. Lifestyle-based interventions in older adults should be tailored towards current levels of motivation and self-efficacy of participants. Including modules targeting motivation and self-efficacy might help maximize intervention effectiveness.

Keywords: Alzheimer's disease; aged; diet; healthy aging; motivation; primary prevention; self efficacy; transtheoretical model.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dementia* / epidemiology
  • Dementia* / prevention & control
  • Dementia* / psychology
  • Diet, Healthy* / psychology
  • Feeding Behavior* / psychology
  • Female
  • Germany / epidemiology
  • Health Behavior*
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Risk Factors
  • Self Efficacy