Disentangling Responsibility: Perspectives on Dementia Prevention From Stakeholders in Canada, Germany and Switzerland.

Abstract

Dementia prevention has become a priority in medical research and public health. Various medical, social and environmental risk factors have been identified; however, medical studies, media discourses and health policies predominantly centre on individual-level prevention and promote personal responsibility for maintaining cognitive health. This emphasis on individual preventive efforts faces increasing criticism for being ethically problematic, medically insufficient and reflective of a neoliberal responsibilisation of (cognitive) ageing. Our study, based on 60 semi-structured qualitative interviews with stakeholders involved in dementia research, care and health policy from Canada, Germany and Switzerland, situates the preventive turn within contemporary ageing cultures and welfare policies. By examining the epistemic and normative arguments underlying current debates on dementia prevention, we illustrate how stakeholders justify both personal and governmental responsibilities in preventing dementia. Although managing and mitigating various risk factors throughout life is often framed as a matter of personal responsibility, many stakeholders advocate combining individual-level prevention with population-level efforts to address social inequalities that affect the risk of developing dementia. Drawing on the interview study, we highlight the importance of recognising the political and normative foundations and implications of dementia prevention strategies.