“Not for Our Age”: Self-Ageism in Older Adults’ Dementia Screening Decision

BACKGROUND AND OBJECTIVES: To explore age-specific insights into how older adults understand and decide about health screening, using dementia screening as a critical case. RESEARCH DESIGN AND METHODS: Participants were 44 community-dwelling older adults in Singapore (ages 64-87). Six focus group discussions (FGDs) were conducted. Audio recordings were transcribed, standardized into English, and verified through independent bilingual checks. Data were analyzed using a hybrid inductive-deductive thematic analysis grounded in Health Belief Model constructs. RESULTS: Six main themes with twelve subthemes were identified from the analysis. Dementia understanding described participants' general awareness of dementia and confusion between normal ageing and cognitive impairment. Risk perceptions included perceived severity and susceptibility, with many viewing dementia as an inevitable part of ageing rather than something preventable. Perceived benefits encompassed early detection, improved awareness, and protection of family members through future planning. Perceived barriers involved both practical and psychological factors, including financial cost, accessibility, fear of diagnosis, and concerns over autonomy loss. Perceived support highlighted the influence of family encouragement, community resources, and spiritual faith in motivating or discouraging screening decisions. An emergent theme of self-ageism reflected internalized beliefs that screening was unnecessary, inappropriate, or futile in later life. DISCUSSION AND IMPLICATIONS: Dementia screening, as a critical case, revealed how self-ageism, alongside conventional HBM constructs, shapes older adults' screening intentions, underscoring the need for inclusive health communication for aging populations.