Socioeconomic differences in dementia risk, lifestyle, and relevant determinants of behavior

Background: Dementia affects over 55 million people worldwide, with numbers expected to triple by 2050. While multi-domain interventions focus on physical activity and diet, limited attention has been paid to routine social and cognitively stimulating activities. Evidence for these activities is limited due to methodological challenges and inconsistent measurement. A clear conceptual framework is needed to define and measure relevant attributes of such activities.Objective: This study explores attributes and motivational aspects that make activities cognitively and socially stimulating from the perspective of Dutch middle-aged and older adults.Methods: This qualitative study is part of a triangulated research project aiming to develop a validated conceptual model. Semi-structured interviews were conducted with 22 adults from South-Limburg, The Netherlands. A deductive thematic analysis was performed on 10 interviews using Atlas.ti software. Coding was conducted by two researchers using open and axial coding methods. Codes were discussed in consensus meetings and visualized through a mind map. Findings were linked to a preliminary model derived from literature and expert input.Results: Participants confirmed core model attributes such as mental activation, challenge, novelty, and interaction with others. In addition, new attributes emerged: concentration, weak social ties, and the role of personal disposition and contextual factors. Most notably, purpose (e.g., enjoyment, fulfillment, health goals) was consistently described as a key motivational driver, often overriding other factors.Conclusion: These findings highlight the importance of integrating motivational elements, particularly personal purpose, into the conceptual model and dementia prevention strategies. They offer valuable input for improving measurement tools and support the development of tailored interventions that move beyond a one-size-fits-all approach.