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

Background: Healthy 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. Objective: To analyze dietary habits and associated factors in older adults with increased dementia risk in Germany. Methods: We 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. Results: Consumption 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. Conclusions: Results 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.