Assignment 2

Gaps in Alzheimer’s Knowledge Among College Students

Elaine M. Eshbaugh

School of Applied Human Sciences, University of Northern Iowa, Cedar Falls, Iowa, USA

Despite the prevalence of the disease, it appears that there may be a need for increased education for

formal and family caregivers of those with Alzheimer’s disease and related dementias. Today’s

college students will be asked to fill both of these roles in the future. This study examined the level

of knowledge of Alzheimer’s disease among college students. Two-hundred college students at a

mid-sized midwestern university completed an online survey that included the Alzheimer’s Disease

Knowledge Scale (Carpenter et al., 2009). Although most participants knew that people with

Alzheimer’s remember things from the distant past better than more recent events, many college

students were unfamiliar with risk factors and average life expectancy. Implications and recommen-

dations for educational programs and curriculum are discussed.

Alzheimer’s disease and related dementias are significant health concerns affecting our older

adult population (Sullivan & Muscat, 2007). As our population continues to age and our

demography shifts to higher proportions of elders, the number of individuals diagnosed with

Alzheimer’s and dementia continues to increase. Although the causes of dementia are numerous,

Alzheimer’s disease, which is irreversible and ultimately fatal, is the most common cause of

dementia. About 70% of dementias in the United States are caused by Alzheimer’s disease (Brookmeyer, Evans, Hebert, Langa, & Herringa, 2011). This percentage increases to nearly

80% among those 90 years old or greater who have dementia (Brookmeyer et al., 2011). Strikingly, one in eight persons in the U.S. aged 65 years or older has Alzheimer’s disease

(Hebert, Scherr, Bienias, Bennett, & Evans, 2003). Because the Baby Boom generation is

reaching the age of greatest risk for dementia and Alzheimer’s disease, the number of individuals

living with dementia in the U.S. will increase in the next several decades barring the develop-

ment a significant medical breakthrough.

Despite the prevalence of Alzheimer’s and related dementias, it appears that there may be a

need for increased education among both family and professional caregivers. Research suggests

that families, in particular, are often overwhelmed by the caregiving needs of those with

dementia and lack the knowledge to confidently provide for those needs (Manthrope & Iliffe,

2009). Unfortunately, families of those with dementia, particularly early stage dementia, have

substantial educational needs that are not always met (Moniz-Cook & Woods, 1997). Caregivers

Address correspondence to Elaine M. Eshbaugh, University of Northern Iowa, School of Applied Human Sciences,

217 Latham Hall, Cedar Falls, IA 50614-0332. E-mail: [email protected]

Educational Gerontology, 40: 655–665, 2014

Copyright # Taylor & Francis Group, LLC

ISSN: 0360-1277 print / 1521-0472 online

DOI: 10.1080/03601277.2013.863573

also may be reluctant to ask questions and may not know how to make sure their need for

education is met (Boise, Morgan, Kaye, & Camicolli, 1999).

It follows that less than adequate levels of knowledge of Alzheimer’s among family

caregivers have been found, particularly among spouses of those with the disease and those fam-

ily members with low levels of education (Werner, 2001). Family caregivers show a lack of

knowledge in the areas of prevalence, symptoms, and causes of the disease. This is notable

because 80% of care provided at home for those with Alzheimer’s is provided by family members, and 15 million Americans provide unpaid, informal care for a loved one living with

Alzheimer’s or another dementia (Alzheimer’s Association, 2012).

However, it should be noted that there is some evidence that first-degree relatives of those

with Alzheimer’s have a relatively high level of knowledge about the disease compared to other

populations (Roberts & Connell, 2000). Persons who have a family member with Alzheimer’s

typically know more about the disease than persons who do not have a family member with the

disease (Carpenter, Zoller, Balsis, Otilingham, & Gatz, 2011). In addition, family caregivers

participating in Alzheimer’s support groups may have more knowledge of the disease than other

caregivers (Graham, Ballard, & Sham, 1997). Not surprisingly, family caregivers may be more

capable of negotiating the demands of dementia and effectively implementing treatment plans

when they have a better understanding of Alzheimer’s (Sullivan & Muscat, 2007). Caregivers

with more understanding of the illness can be more active in the care of their loved one

(Ham, 1999) and be more rational decision-makers (Werner, 2001).

Lack of knowledge about Alzheimer’s is not only problematic in the case of family caregivers.

It may also be an issue for professional caregivers. Unfortunately, there is a shortage of healthcare

professionals and social workers who can knowledgably and effectively provide services for those

with dementia (Bartels & Smyer, 2002). More specifically, survey research has suggested that

there is a need for healthcare and social service professionals to be more empathetic and under-

standing of the needs of those with dementia and their families (Thompson, Hope, & Pulsford,

2009). Research has suggested that knowledge of dementia among professionals is important

because it leads to earlier diagnosis and more competent referrals for those with dementia (Reimer,

Slaughter, Donaldson, Currie, & Eliaziw, 2004). Furthermore, dementia training can increase

professionals’ competence in managing the behaviors of those with dementia (Hughes, Bagley,

Reilly, Burns, & Challis, 2008). Although some researchers (Carpenter et al., 2011) have found

that caregiving professionals are more familiar with the disease and have greater levels of

knowledge than families, there may still be a need for increased education among this group.

It is also important to consider the level of knowledge of Alzheimer’s disease among college

students. Obviously, they are future family and professional caregivers. Even those college stu-

dents who will pursue careers that require interaction with individuals with Alzheimer’s may

lack knowledge. Undergraduates, including those intending to pursue careers in the healthcare

and social services area, tend to have an inadequate level of knowledge about Alzheimer’s

(Kwok, Yip, & Ho, 2011). They may have a low level of knowledge about dementia drugs

and their limited effectiveness, in particular. Research has suggested that nursing students

who interact with individuals with dementia receive little education on care (Pulsford, Hope,

& Thompson, 2007). Furthermore, students’ knowledge of the cognition of older adults may

be limited by their overgeneralization of the elders that they come into contact with, such as fam-

ily members and friends (Jackson, Cherry, Smitherman, & Hawley, 2008). In other words, they

often underestimate the diversity in the cognitive functioning of older adults.

656 E. M. ESHBAUGH

Education for future health and social work professionals is variable in level and type of

dementia coverage, and this variability may result in a work force with deficient skills in

working with those who have dementia. Authors (Nordhus, Sivertsen, & Pallesen, 2012) have

suggested that a challenge is strengthening the Alzheimer’s knowledge base of those who will

work in mental health settings with our aging global population. In addition, even those students

who do not seek careers in working with older adults and their families will likely be confronted

with family members and friends of their own with dementia. Increasing knowledge of

Alzheimer’s among these potential informal and unpaid caregivers may serve to reduce future

caregiver stress, decrease early institutionalization, and increase access of support services

(Bailey, 2000). Therefore, it is important to examine the level of knowledge of undergraduates

have regarding Alzheimer’s disease and related dementias.

PURPOSES OF THE STUDY

Provide Further Validation of the ADKS with a College Student Sample

In 1988, the Alzheimer’s Disease Knowledge Test (Diekman, Zarit, Zarit, & Gatz, 1988) was

developed as a 20-item multiple choice assessment to determine what individuals know about

Alzheimer’s disease. The test was used for assessment in various populations including college

students and health professionals. Although the knowledge reflected in this measure became

dated due to advances in knowledge in the field of Alzheimer’s and dementia, researchers

continued to use the test until the development of the Alzheimer’s Disease Knowledge Scale

(ADKS) in 2009 (Carpenter et al., 2009).

The ADKS, a 30-item, true=false measure, takes 5–10 minutes to complete. Respondents receive one point for each correct answer for a maximum of 30 points. This measure can be used

to examine individuals’ levels of knowledge about Alzheimer’s for a variety of purposes such as

targeting educational needs. Furthermore, administering the assessment can help to make

individuals aware of what they do not know about Alzheimer’s disease and be an educational

tool in itself.

The ADKS has been validated for use with groups such as senior center staff, dementia

caregivers, dementia professionals, older adults, and college students (Carpenter et al., 2009).

Group differences in knowledge of Alzheimer’s were generally in the expected directions, with

dementia professionals having the greatest level of knowledge. The scale’s authors suggest

further research to confirm the reliability and validity of the scale with various populations.

The current study aimed to further validate the assessment for use with college students.

Determine the Level of Knowledge and Identify Gaps in Knowledge Among College Students

It has been recommended that collegiate programs educating students, particularly those students

who may work with individuals who have dementia, incorporate more dementia-related material

into the curriculum (Kwok et al., 2011). It has even been suggested that such additions to the

curriculum could increase students’ interest in working with an aging population (Sullivan &

GAPS IN ALZHEIMER’S KNOWLEDGE AMONG COLLEGE STUDENTS 657

O’Conor, 2001). Yet, more specific recommendations need to be made in order to create

programs that target gaps in knowledge among students.

Gerontological researchers have been called on to identify what students do and do not know

about memory in aging because this is the first step in developing educational programs (Jackson

et al., 2008). These educational programs are an integral part of developing a work force to meet

the demands of our aging population. Furthermore, college students are likely to be called on in

the future as informal caregivers for our aging population. Those who do not choose a career

path working with individuals who have dementia are likely to be part of a network of family,

friends, neighbors, and community members that are asked to provide support for those living

with Alzheimer’s and related dementias. For this reason, it is important to identify common

misconceptions that college students have about Alzheimer’s and determine what gaps this

population has in its knowledge of the disease.

METHOD

Participants

After Institutional Review Board approval was obtained, college students (N ¼ 200) in several large lecture courses at a mid-sized midwestern university were sent an e-mail by their instructor

asking them to complete an online survey through SurveyMonkey.com. The online survey

took about 7–10 minutes to complete. Data for this study were collected over two consecutive

semesters.

Over 60% (n ¼ 121) of participants were female. Participants ranged in age from 18 to 59 years (M ¼ 22.71, SD ¼ 3.21). Eight percent (n ¼ 16) of students were freshmen; 12% (n ¼ 24) sophomores; 17% (n ¼ 34) juniors; and 11.5% (n ¼ 79) seniors. In addition, 47 participants identified themselves as graduate students. Students indicated diverse majors, such as education

(n ¼ 42), business (n ¼ 23), psychology (n ¼ 22), and family services (n ¼ 18). More than 81% of students (n ¼ 163) identified themselves as European-American. Nineteen (9.5%) were African- American, and eight (4%) were Hispanic. Two participants identified as multiracial, and two participants identified as other.

Twenty-two respondents (11%) indicated that they currently work, or have worked, in a nurs- ing home. Thirty-two (16%) currently work, or have worked in a health care setting. Seventy-six students (38%) reported that one of their loved ones currently had Alzheimer’s disease or dementia or had experienced Alzheimer’s disease or dementia in the past. Twenty-nine parti-

cipants (14.5%) had been a caregiver for a loved one with Alzheimer’s disease.

Measures

Demographics

Participants were asked to indicate their gender, age, major, and intended future career. They were

asked to indicate whether or not they had received any information on Alzheimer’s disease in their

college courses. In addition, they were asked whether or not they had worked in a nursing home or a

health care setting and whether or not they had ever had a loved one with Alzheimer’s disease.

658 E. M. ESHBAUGH

Self-Reported Alzheimer’s Knowledge

Participants were asked to rate their knowledge of Alzheimer’s disease by responding to the

following item: ‘‘I feel that I know a lot about Alzheimer’s disease.’’ Response choices ranged

from 1: strongly disagree to 5: strongly agree.

Alzheimer’s Disease Knowledge Scale (Carpenter et al., 2009)

The Alzheimer’s Disease Knowledge Scale (ADKS) is a 30-item true=false questionnaire designed to assess knowledge of Alzheimer’s disease. Test-retest reliability is .81 over intervals

of 2-to-50 hours. Internal consistency reliability for the scale is .71, but the internal consistently

was only .55 in a preliminary study of college students (Carpenter et al., 2009). Although the

scale identifies items with one of six content areas (course, risk factors, symptoms, treatment

and management, assessment and diagnosis, and caregiving), Carpenter et al. suggest the scale

is best-used as an overall knowledge scale rather than as separate subscales.

RESULTS

The mean on the ADKS was 20.78 (SD ¼ 4.24, min. ¼ 12, max. ¼ 29). Fifty-seven percent (n ¼ 114) of participants had more than 20 correct responses on the scale. Cronbach’s alpha was .70. No items on the scale had an item-difficulty index of more than .95, meaning that

95% or less indicated the correct response on each item. Only one item (‘‘It has been scientifi- cally proven that mental exercise can prevent a person from getting Alzheimer’s disease’’) had a

significant, negative item-total correlation (see Table 1). Twenty-one of the 30 items had a

significant positive item-total correlation at the .05 level.

The mean for women on the ADKS was 20.49 (SD ¼ 4.45), and the mean for men was 20.97 (SD ¼ 4.11). ADKS scores did not differ significantly by gender, t (198) ¼ .77, p ¼ .44. Number of years of college completed was positively corrected with the ADKS, r ¼ .30, p < .001, indi- cating that students who had completed a greater number of years of college had a greater

knowledge of Alzheimer’s. Age was also significantly and positively correlated with the ADKS,

r ¼ .17, p < .02. Participants who indicated that they had a loved one who currently has or has had

Alzheimer’s (M ¼ 21.30, SD ¼ 4.46) had slightly, but not significantly, higher ADKS scores than other participants (M ¼ 20.45, SD ¼ 4.09; t (198) ¼ 1.36, p ¼ .17). The students who indi- cated that they had been a caregiver for a loved one with Alzheimer’s (M ¼ 22.03, SD ¼ 3.96) did not show statistically significant greater levels of knowledge than other students (M ¼ 20.56, SD ¼ 4.26; t (198) ¼ 1.73, p ¼ .08). Over half (50.5%; n ¼ 101) of the participants indicated that they had received some information on Alzheimer’s throughout their college coursework, and

these students had higher scores on the ADKS (M ¼ 21.63, SD ¼ 4.49) than did other students (M ¼ 19.91, SD ¼ 3.81; t (198) ¼ 2.93, p < .01)

On a scale of 1 to 5, the mean for self-reported knowledge of Alzheimer’s was 3.04

(SD ¼ 1.01). Responses ranged from 1 to 5, with 37% (n ¼ 74) indicating that they agreed or strongly agreed with the statement ‘‘I feel that I know a lot about Alzheimer’s disease.’’ There

was a significant positive correlation between self-reported knowledge of Alzheimer’s and the

GAPS IN ALZHEIMER’S KNOWLEDGE AMONG COLLEGE STUDENTS 659

T A B L E 1

A lz h e im

e r’ s D is e a s e K n o w le d g e S c a le

(N ¼ 2 0 0 )

It em

C o n te n t

C o rr ec t

R es p o n se

N u m b er

R es p o n d in g

C o rr ec tl y (%

) It em

-T o ta l

C o rr el a ti o n

P e o p le

w it h A lz h e im

e r’ s d is e a se

a re

p a rt ic u la rl y p ro n e to

d e p re ss io n .

L if e im

p a c t

T ru e

1 4 8 (7 4 .0 )

.6 3 �

It h a s b e e n sc ie n ti fi c a ll y p ro v e n th a t m e n ta l e x e rc is e c a n p re v e n t a p e rs o n

fr o m

g e tt in g A lz h e im

e r’ s d is e a se .

R is k fa c to rs

F a ls e

8 6 (4 3 .0 )

� .1 8 �

A ft e r sy m p to m s o f A lz h e im

e r’ s d is e a se

a p p e a r, th e a v e ra g e li fe

e x p e c ta n c y

is 6 to

1 2 y e a rs .

C o u rs e

T ru e

1 1 9 (5 9 .5 )

.3 0 �

W h e n a p e rs o n w it h A lz h e im

e r’ s d is e a se

b e c o m e s a g it a te d , a m e d ic a l

e x a m in a ti o n m ig h t re v e a l o th e r h e a lt h p ro b le m s th a t c a u se d th e a g it a ti o n .

A ss e ss m e n t a n d d ia g n o si s

T ru e

1 5 0 (7 5 .0 )

.4 9 �

P e o p le w it h A lz h e im

e r’ s d is e a se

d o b e st w it h si m p le , in st ru c ti o n s g iv e n o n e

st e p a t a ti m e .

C a re g iv in g

T ru e

1 6 9 (8 4 .5 )

.6 1 �

W h e n p e o p le

w it h A lz h e im

e r’ s d is e a se

b e g in

to h a v e d if fi c u lt y ta k in g c a re

o f th e m se lv e s, c a re g iv e rs

sh o u ld

ta k e o v e r ri g h t a w a y .

C a re g iv in g

F a ls e

1 2 0 (6 0 .0 )

.1 0

If a p e rs o n w it h A lz h e im

e r’ s d is e a se

b e c o m e s a le rt a n d a g it a te d a t n ig h t, a

g o o d st ra te g y is to

tr y to

m a k e su re

th a t th e p e rs o n g e ts p le n ty

o f p h y si c a l

a c ti v it y d u ri n g th e d a y .

C a re g iv in g

T ru e

1 4 6 (7 3 .0 )

.4 1 �

In ra re

c a se s, p e o p le

h a v e re c o v e re d fr o m

A lz h e im

e r’ s d is e a se .

C o u rs e

F a ls e

1 6 2 (8 1 .0 )

.0 3

P e o p le

w h o se

A lz h e im

e r’ s d is e a se

is n o t y e t se v e re

c a n b e n e fi t fr o m

p sy c h o th e ra p y fo r d e p re ss io n a n d a n x ie ty .

T re a tm

e n t a n d m a n a g e m e n t

T ru e

1 2 3 (6 1 .5 )

.4 4 �

If tr o u b le w it h m e m o ry

a n d c o n fu se d th in k in g a p p e a rs su d d e n ly , it is li k e ly

d u e to

A lz h e im

e r’ s d is e a se .

A ss e ss m e n t a n d d ia g n o si s

F a ls e

1 5 5 (7 7 .5 )

.1 5 �

M o st p e o p le

w it h A lz h e im

e r’ s d is e a se

li v e in

n u rs in g h o m e s.

L if e im

p a c t

F a ls e

1 2 0 (6 0 .0 )

.0 8

P o o r n u tr it io n c a n m a k e th e sy m p to m s o f A lz h e im

e r’ s d is e a se

w o rs e .

T re a tm

e n t a n d c a re g iv in g

T ru e

1 4 0 (7 0 .0 )

.6 0 �

P e o p le

in th e ir 3 0 ’s

c a n h a v e A lz h e im

e r’ s d is e a se .

R is k fa c to rs

T ru e

1 3 4 (6 7 .0 )

.4 7 �

A p e rs o n w it h A lz h e im

e r’ s d is e a se

b e c o m e s in c re a si n g ly

li k e ly

to fa ll

d o w n a s th e d is e a se

g e ts w o rs e .

C o u rs e

T ru e

1 2 5 (6 2 .5 )

.4 3 �

660

W h e n p e o p le

w it h A lz h e im

e r’ s d is e a se

re p e a t th e sa m e q u e st io n o r st o ry

se v e ra l ti m e s, it is h e lp fu l to

re m in d th e m

th a t th e y a re

re p e a ti n g

th e m se lv e s.

C a re g iv in g

F a ls e

1 7 3 (8 6 .5 )

.2 1 �

O n c e p e o p le

h a v e A lz h e im

e r’ s d is e a se , th e y a re

n o lo n g e r c a p a b le

o f

m a k in g in fo rm

e d d e c is io n s a b o u t th e ir o w n c a re .

C a re g iv in g

F a ls e

1 5 0 (7 5 .0 )

.1 8 �

E v e n tu a ll y , a p e rs o n w it h A lz h e im

e r’ s d is e a se

w il l n e e d 2 4 -h o u r

su p e rv is io n .

C o u rs e

T ru e

1 1 4 (7 2 .0 )

.4 2 �

H a v in g h ig h c h o le st e ro l m a y in c re a se

a p e rs o n ’s

ri sk

o f d e v e lo p in g

A lz h e im

e r’ s d is e a se .

R is k fa c to rs

T ru e

6 5 (3 2 .5 )

.4 4 �

T re m o r o r sh a k in g o f th e h a n d s o r a rm

s is a c o m m o n sy m p to m

in p e o p le

w it h A lz h e im

e r’ s d is e a se .

S y m p to m s

F a ls e

1 1 4 (5 7 .%

) � .0 4

S y m p to m s o f se v e re

d e p re ss io n c a n b e m is ta k e n fo r sy m p to m s o f

A lz h e im

e r’ s d is e a se .

A ss e ss m e n t a n d d ia g n o si s

T ru e

1 0 3 (5 1 .5 )

.5 1 �

A lz h e im

e r’ s d is e a se

is o n e ty p e o f d e m e n ti a .

A ss e ss m e n t a n d d ia g n o si s

T ru e

1 6 5 (8 2 .5 )

.4 8 �

T ro u b le

h a n d li n g m o n e y o r p a y in g b il ls is a c o m m o n e a rl y sy m p to m

o f

A lz h e im

e r’ s d is e a se .

S y m p to m s

T ru e

1 2 9 (6 4 .5 )

.6 2 �

O n e sy m p to m

th a t c a n o c c u r w it h A lz h e im

e r’ s d is e a se

is b e li e v in g th a t

o th e r p e o p le

a re

st e a li n g o n e ’s

th in g s.

S y m p to m s

T ru e

1 5 4 (7 7 .0 )

.6 7 �

W h e n a p e rs o n h a s A lz h e im

e r’ s d is e a se , u si n g re m in d e r n o te s is a c ru tc h

th a t c a n c o n tr ib u te

to d e c li n e .

T re a tm

e n t a n d m a n a g e m e n t

F a ls e

1 5 2 (7 6 .0 )

.0 3

P re sc ri p ti o n d ru g s th a t p re v e n t A lz h e im

e r’ s d is e a se

a re

a v a il a b le .

R is k fa c to rs

F a ls e

1 6 5 (8 2 .5 )

.0 2

H a v in g h ig h b lo o d p re ss u re

m a y in c re a se

a p e rs o n ’s

ri sk

o f d e v e lo p in g

A lz h e im

e r’ s d is e a se .

R is k fa c to rs

T ru e

7 1 (3 5 .5 )

.4 1 �

G e n e s c a n o n ly

p a rt ia ll y a c c o u n t fo r th e d e v e lo p m e n t o f A lz h e im

e r’ s

d is e a se .

R is k fa c to rs

T ru e

1 5 3 (7 6 .%

) .6 1 �

It is sa fe

fo r p e o p le w it h A lz h e im

e r’ s d is e a se

to d ri v e , a s lo n g a s th e y h a v e

a c o m p a n io n in

th e c a r a t a ll ti m e s.

L if e im

p a c t

F a ls e

1 6 9 (8 4 .5 )

.0 5

A lz h e im

e r’ s d is e a se

c a n n o t b e c u re d .

T re a tm

e n t a n d m a n a g e m e n t

T ru e

1 6 7 (8 3 .5 )

.4 7 �

M o st p e o p le

w it h A lz h e im

e r’ s d is e a se

re m e m b e r re c e n t e v e n ts b e tt e r th a n

th in g s th a t h a p p e n e d in

th e p a st .

S y m p to m s

F a ls e

1 8 5 (9 2 .5 )

.0 1

N o te . p < .0 5 is d e n o te d b y

� .

661

ADKS, r (198) ¼ .25, p < .001. In other words, students who reported that they had a greater level of knowledge about Alzheimer’s scored higher on the ADKS.

What College Students Know About Alzheimer’s Disease (See Table 1)

Greater than 90% of participants correctly identified that ‘‘Most people with Alzheimer’s disease remember recent events better than things that happened in the past’’ is false, and greater than

85% responded correctly to ‘‘When people with Alzheimer’s disease repeat the same question or story several times, it is helpful to remind them that they are repeating themselves.’’ In addition,

84.5% responded correctly to ‘‘It is safe for people with Alzheimer’s disease to drive, as long as they have a companion in the car at all times, and 83.5% responded correctly to ‘‘Alzheimer’s disease cannot be cured.’’ Furthermore, 82.5% knew that ‘‘Alzheimer’s disease is one type of dementia,’’ and 82.5% indicated the correct answer to ‘‘Prescription drugs that prevent Alzheimer’s disease are available.’’

What College Students Don’t Know About Alzheimer’s Disease (See Table 1)

Only 32.5% responded correctly to ‘‘Having high cholesterol may increase a person’s risk of devel- oping Alzheimer’s disease.’’ In addition, 35.5% of participants responded correctly to ‘‘Having high blood pressure may increase a person’s risk of developing Alzheimer’s disease,’’ and 43% responded correctly to the item ‘‘It has been scientifically proven that mental exercise can prevent

a person from getting Alzheimer’s disease.’’ It should be noted that all three of these items focus on

‘‘risk factors’’ as classified by the authors of the ADKS (Carpenter et al., 2009, pp. 240–241).

DISCUSSION

The mean on the ADKS for this college-student sample was 20.78. By way of comparison, a

college-student sample in the original study using the ADKS had a mean of 20.19 (Carpenter,

et al., 2009). In the same study, older adults had a mean of 24.01, dementia professionals 27.40,

dementia caregivers 22.70, and senior center staff 20.15. The internal consistency for college

students in previous research is only .55 (Carpenter et al., 2009). However, it was more

acceptable (.70) in the present study of students.

A particular area of weakness for students in the present study was risk factors. This is a trend

that was also evident in Carpenter et al.’s (2009) research. Students were generally unaware that

factors such as high blood pressure and increased cholesterol were linked to a greater risk of

Alzheimer’s disease. Educational programs and curriculum may want to focus on increasing stu-

dent knowledge of risk factors, particularly because having adequate knowledge of risk factors

might encourage healthy habits throughout the lifespan. However, most students had an under-

standing that it is not effective to remind people with Alzheimer’s disease that they are repeating

themselves, and most knew that Alzheimer’s impacts short-term memory more severely than

long-term memory.

Students who indicated that they had coursework pertaining to Alzheimer’s disease had a

greater level of knowledge. Of course, this might be because those who were more receptive

to learning about the disease were likely to enroll in courses with relevant content. Interestingly,

662 E. M. ESHBAUGH

participants with a loved one who had experienced Alzheimer’s did not have significantly great-

er knowledge. One explanation is that having a family member diagnosed does not necessarily

cause a person to seek out resources or learn more about the disease. This could also be because

the students in the study had an older relative diagnosed with Alzheimer’s when the student was

too young to fully understand the effects of the disease. They may have also been sheltered from

the impact of the disease as children. Unfortunately, participants were not asked to give more

details about their family member with Alzheimer’s (e.g., how old the student was when their

family member was diagnosed, if the family member was still living, how far away the family

member lived). Although neglected in the present study, these may be key factors to explore

when determining the impact of having a loved one with Alzheimer’s on the level of knowledge

a college student has about the disease.

Recommendations for Educational Program Development

A primary purpose of this research is to identify areas of focus for Alzheimer’s curricula at the

college level. This information could be conveyed in traditional course formats or in educational

seminars or opportunities outside the classroom. Interdisciplinary faculty from a variety of

areas (e.g., health, psychology, gerontology, social work, family studies) could play a role in

educating the student population on Alzheimer’s and related dementias.

First, any Alzheimer’s education should stress that there is no cure and that the disease is

terminal. Over 80% of students correctly indicated that there was no cure for Alzheimer’s. There were many items that proved to be more difficult than this item for the student sample, but it should

still be noted that 16.5% indicated that they think Alzheimer’s disease can be cured. According to the present study, 19% of students think that people have recovered from Alzheimer’s disease. Of course, thinking that Alzheimer’s disease is curable or reversible could set an individual and

family up for false hope when a loved one is diagnosed. Furthermore, a significant minority of

individuals who think that Alzheimer’s is curable could hamper fundraising efforts to help those

affected and to end Alzheimer’s. As the Baby Boom generation ages, individuals of all ages will be

notified that family members, friends, coworkers, and acquaintances have been diagnosed with

Alzheimer’s. A person who hears this news but does not realize this is a fatal disease with no cure

could respond quite inappropriately and risk being perceived as insensitive and unsupportive.

Based on this research, another recommendation would be to emphasize risk factors for

Alzheimer’s disease. In general, students were unaware that high cholesterol and high blood

pressure may increase a person’s risk of developing the disease. Although over 75% of students indicated that they knew genes were only partially responsible for the development

of Alzheimer’s, they did not correctly identify what other risk factors were. It is important to

address this lack of knowledge because individuals should be aware of what they can do to lower

their risk of having the disease. Obviously, we are hopeful that a cure is on the horizon. Until

then, people should be educated about health behaviors that can decrease their likelihood of

developing Alzheimer’s and other dementias.

Furthermore, it might be useful to emphasize to students that severe depression can be mis-

taken for symptoms of Alzheimer’s (and vice versa). Only about half of this sample responded

correctly to this item. It is of particular importance that individuals understand the potential over-

lap between depression and dementia symptoms. There are prescription medications available

GAPS IN ALZHEIMER’S KNOWLEDGE AMONG COLLEGE STUDENTS 663

for those with dementia, and there are drugs prescribed to those with depression. There are also

support groups and other resources available. For this reason, it is key that individuals are

diagnosed accurately as early as possible after significant changes occur so they can receive

appropriate medication and referrals. Family members and friends should encourage individuals

to seek medical care when they experience major changes and avoid making assumptions about

diagnosis.

Many participants indicated that the majority of individuals who have Alzhiemer’s disease

live in nursing homes. In fact, this is not the case. Persons with Alzheimer’s commonly live

in the community, and some even live alone. Assuming that Alzheimer’s is a disease that is iso-

lated to nursing homes is problematic for many reasons. For example, if family members believe

that most people with Alzheimer’s live in nursing homes, they may assume in the future that

their loved ones, if diagnosed with the disease, must immediately move to a nursing home. Most

individuals with Alzheimer’s prefer to stay in their home as long as possible, and hastening the

process of moving to a nursing home may not improve their quality of life. Furthermore, there

are many resources that can help people with dementia live in their own homes after diagnosis.

Assuming that someone who has dementia must live in a nursing home might prohibit family

members from seeking out these resources. In addition, it is important for community members

to realize that they will come in contact with individuals who have Alzheimer’s at places like the

grocery store, the coffee shop, or at a local fast food restaurant. If someone shows symptoms of

dementia at the grocery checkout or while ordering at a restaurant, it is key that their fellow com-

munity members show patience and understanding rather than frustration.

CONCLUSIONS

Despite the prevalence of Alzheimer’s in today’s aging society, it is disease that is misunder-

stood and stigmatized. Today’s college students subscribe to many myths about the disease,

and these misconceptions may have negative consequences for individuals, families, and society

because college students are future formal and informal caregivers. Students pursuing careers in

areas such as human services, health care, social work, gerontology, and health promotion

will undoubtedly be confronted with populations who are directly or indirectly impacted by

Alzheimer’s and related dementias. Even those students who do not plan careers in these areas

will not be able to avoid that challenges presented by Alzheimer’s in our society. The prevalence

of this disease indicates it is highly unlikely a college student would not be exposed to a family

member, friend, coworker, or neighbor diagnosed with Alzheimer’s in the future. If today’s col-

lege students do not become caregivers for someone with Alzheimer’s, they will be asked to

support caregivers. For this reason, it is imperative that we focus on providing education on

the disease to young adults. The first step in providing education is developing time-efficient

programs that target gaps in knowledge among this population. This research provides an

empirical basis for development of these programs.

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