Dementia stigma in the United States: variation by target gender, degree of impairment, and respondent characteristics

INTRODUCTION: The rising prevalence of Alzheimer's disease and related dementias (ADRD) poses major public health concerns. Public knowledge about ADRD diverges from scientific consensus, and consequently, public stigma presents barriers to diagnosis and care. METHOD: This study addresses ADRD stigma in the United States using the well-established vignette approach. A stratified quota sample of 1115 adults matching national demographics were randomly assigned to one of six vignettes. Symptoms of the vignette character mirrored the presentation of ADRD and were reviewed by geriatric neuropsychologists for accuracy. RESULTS: Apart from small vignette effects, stigma was shaped by respondent characteristics. Higher stigma was predicted by less knowledge, being male, non-White race, and living in counties with higher ADRD prevalence. Surprisingly, personal contact showed no effect. DISCUSSION: Rehumanizing individuals with ADRD and enhancing ADRD knowledge should be public health priorities. Stigma reduction efforts need to address informational deficits and narratives that perpetuate negative perceptions.