Motivational and cognitive pathways to medical help-seeking for Alzheimer's disease: a cognitive impairment response model.

OBJECTIVES Relationships among cognitive and motivational factors in predicting medical help-seeking for Alzheimer's disease (AD) symptoms were tested. METHOD Community residents awaiting jury service (N = 280) completed questionnaires, including responses to a vignette depicting prototypical early symptoms of AD in a hypothetical mother. Cognitive responses to the vignette included AD symptom identification and AD attribution. Affective-motivational responses to vignettes were symptom impact and behavior appraisals. General knowledge of AD was assessed. Intention to seek medical help was the dependent variable. RESULTS The impact and identification of AD symptoms, appraisals of risk, and attribution of the scenario to AD were modest, yet all contributed to prediction of medical-help-seeking intentions. The best fitting model had distinct but interrelated cognitive and motivational paths explaining 49% of the variability in medical help-seeking. Motivational variables had particularly important direct and indirect effects on help-seeking. DISCUSSION Findings are interpreted as evidence of the importance of motivational as well as cognitive aspects of perceptions of illness behavior in another person. The substantial impact of the tested variables on the desired outcome of medical help-seeking may suggest options for public health efforts to enhance early medical help-seeking for AD that sets the stage for early intervention.