Abstract Body: Background: Dementia and stroke are major contributors to mortality and morbidity, largely due to modifiable risk factors. Despite widespread awareness, health-related behaviors that reduce these risks remain suboptimal. This study aims to (i) cluster and characterize subgroups based on their recognition of modifiable risk factors and associated health-related behaviors for dementia and stroke, and (ii) identify the corresponding facilitators and barriers.

Methods: We conducted an online survey of the U.S. population via Prolific. Participants were assessed on their recognitions of the importance of eight modifiable risk factors for maintaining brain health (alcohol, diet, physical activity, smoking, sleep, stress, social relationships, and purpose in life) and the corresponding health behaviors based on international guidelines. Hierarchical cluster analysis was performed to identify clusters, which were then compared based on demographics. A correlation network analysis was conducted to explore relationships between recognitions, health behaviors, facilitators, barriers, and demographics.

Results: Among 1,478 participants (mean age: 45.5y ; 51.8% female), the proportion who perceived a risk factor as important for brain health was higher than the proportion who engaged in the corresponding healthy behaviors across all eight risk factors (Fig 1). Three clusters emerged: (I) high recognition/low health-related behavior, (II) high recognition/high health-related behavior, and (III) lower recognition/low health-related behavior (Fig 2). Individuals in the high recognition/high health-related behavior cluster were significantly older, more educated, and reported fewer barriers, such as financial and time constraints, and more facilitators, including personal motivation and experiences with dementia and stroke. The network analysis revealed that financial barriers had the highest centrality and were strongly correlated with health-related behaviors (Fig 3).

Conclusion: While most participants recognized the importance of modifiable risk factors for brain health, fewer engaged in the corresponding health-related behaviors. The three clusters exhibited varying levels of recognition and healthy behaviors, along with significant differences in demographics, barriers, and facilitators. These findings suggest that targeted interventions should focus on enhancing recognitions in some groups and supporting the translation of recognitions into healthy behaviors in others.