The dementia fear among older adults: a scoping review

Abstract

Background Previous studies evaluating dementia fear among older adults showed inconsistent results regarding its prevalence, measurement approaches, and associated factors. We performed a scoping review to systematically map the literature on measurement tools, prevalence levels, associated factors, and intervention strategies. Methods We systematically searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed from inception to May 2026. Two reviewers independently screened literature and extracted data using a standardized form. Evidence was synthesized narratively. Results Nineteen studies including over 9,000 participants were included: 11 cross-sectional surveys, 2 RCTs, 2 scale development studies, 1 longitudinal study, 1 experimental study, and 2 qualitative studies. Measurement tools were highly heterogeneous; Eight studies used validated multidimensional scales (FADS, FODS-K, DWAS), two used the validated unidimensional Dementia Worry Scale (DWS), while the remaining nine studies relied on single-item or adapted measures Dementia fear was predominantly mild to moderate, but the distribution of study populations was uneven across severity levels. Female gender and depressive symptoms were the most consistently associated factors, though causal directions remained undetermined. Dementia knowledge was positively associated with dementia fear, suggesting knowledge-based strategies alone may amplify rather than alleviate fear. Intervention evidence was extremely limited; only two small-sample RCTs provided preliminary efficacy data. Conclusions Current evidence from existing studies did not support a unified conceptual framework or standardized measurement approach for dementia fear. Future research should develop cross-culturally validated multidimensional instruments, conduct longitudinal studies, and design large-sample intervention trials for different worry severity subgroups. Systematic Review Registration https://osf.io/r54jk/, identifier [10.17605/OSF.IO/R54JK]