A Best–Worst Scaling Study of the General Population's Preferences for Activities in Living Arrangements for Persons With Dementia

Background Activity involvement is a central element of dementia care. However, few studies have examined preferences for types of activities for persons who may be in need of care in the future. In this study, a best–worst scaling (BWS) was conducted to gather insights on preferred activities in small-scale living arrangements for dementia in the general population aged 50–65 years from rural and urban regions. Methods BWS tasks were developed based on literature searches and focus groups. The final BWS contains ten activities, namely ‘interaction with animals’, ‘gardening’, ‘painting, handicrafts, manual activities’, ‘household activities (e.g., folding laundry, cooking)’, ‘watching television’, ‘practicing religion’, ‘listening to music and singing familiar songs’, ‘conversations about the past’, ‘walks and excursions’, ‘sport activities (e.g., gymnastics)’. Each participant had to fill out subsets of four objects each and identify them as best and worst. A postal survey was sent to a total of 4390 persons from rural and urban regions aged between 50 and 65 years. Results were analyzed by count analysis and logit models. It was examined if preferences differ with respect to gender, religiousness, and informal caregiving experience. Results A total of 840 questionnaires were returned, and 627 surveys were included in the analysis. In the rural sample, the highest relative importance (RI) was assigned to ‘walks and excursions’ (RI: 100%), ‘sport activities (e.g., gymnastics)’ (RI: 56%), ‘gardening’ (RI: 28%), and ‘interaction with animals’ (26%). In the urban sample, ‘walks and excursions’ (RI: 100%), ‘sport activities (e.g., gymnastics)’ (RI: 37%), ‘interaction with animals’ (25%) and ‘gardening’ (RI: 22%) were perceived as most important. In both groups, household activities and practicing religion were of lowest importance. Importance ranks differed between subgroups. Results of the logit models with random effects showed the same order as results from the count analyses. Discussion Our findings show that respondents generally favored activities with an outdoor component, while the household activities that are part of many concepts were of low importance to respondents. Thus, our study can inform the design of a preference-based specific range of activities in small-scale living arrangements for dementia.