Knowledge, awareness, and practice of undergraduate medical students on Alzheimer’s disease and dementia in Oman

Abstract

BACKGROUND:

Dementia is an acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. Alzheimer’s disease is the most common type of dementia, which accounts for 60% to 70% of cases. There are no accurate statistics yet on the percentage of Alzheimer’s patients in Oman, and it is expected that the number of patients with this disease will increase. Medical students are exposed to different aspects of Alzheimer’s disease very late in their medical curriculum. Early exposure to the disease will increase the level of awareness and interest in the disease. The study might also help in the curricular changes in terms of integration of Dementia-related topics in neurobiology and other relevant preclinical courses. To assess first-year medical students’ knowledge and attitude toward Alzheimer’s disease and related dementias.

MATERIALS AND METHOD:

A cross-sectional survey was carried out among first-year students at the College of Medicine and Health Sciences, National University, Oman, after getting their consent. The sociodemographic data will be collected from the students initially. We also adapted components from the published and previously tested Alzheimer’s Disease Knowledge Scale, the Alzheimer’s Disease Awareness Scale, and the Dementia Attitudes Scale, in addition to incorporating questions to specifically assess the local practices related to management of the disease.

RESULTS:

127 students participated in the study. 82.7% were females (n = 105), and 17.3% (n = 22) were males. The average age of participants was 19.30 years (SD = 0.769). In our sample, 54.4% of the respondents had correctly identified that loss of memory and forgetting names, appointments, and task repetition in the elderly need medical attention. Approximately half of the students, 47.6%, disagreed that Alzheimer’s disease could be caused by black magic or evil eye. As a whole, 53.1% of participants were against hiding diagnoses and advocated for transparency. On the other hand, 73.4% of participants expressed strong disapproval of socially isolating Alzheimer’s disease patients to prevent them from experiencing personal embarrassment. 56.7% of the students acknowledged the possibility that certain foods, such as fish, leafy greens, and berries, could reduce the chance of developing Alzheimer’s disease. There is a moderate tendency toward belief in the existence of traditional remedies in Oman (45.3%), according to the data, which indicate that there is a mixed assessment of the availability of traditional remedies in Oman.

CONCLUSION:

The study indicates a well-informed understanding of Alzheimer’s disease and dementia within the studied community, especially concerning dietary influences and the possibilities of medicinal interventions. The divergent opinions on standard and alternative medicines suggest that additional education and study could be advantageous. As Alzheimer’s disease research progresses, continuous public education initiatives will be essential to align attitudes with the most recent scientific findings and accessible treatment alternatives.

Introduction

Globally, there is an increase in the older population, whose lives are affected by local cultural norms. In Eastern Mediterranean (EM) countries including Oman, dementia is conventionally hidden from view with a few dedicated services or recognition for diagnosis.

It was estimated that in 2016, 47 million people around the world live with dementia, 2.3 million of whom live in EM countries. By 2030, this number is expected to increase to 4.4 million people living with dementia in EM countries. The increase in the older population in EM is consistent with growth globally (World Health Organization).[1] However, there is marked geographical heterogeneity in these projections of dementia prevalence. While an increase of 53% is expected in the high-income Asia Pacific countries, this rise is expected to be 367% in the Eastern Mediterranean region, with marked increases in Saudi Arabia (898%), Oman (943%), Bahrain (1084%), and the United Arab Emirates (1795%).[2]

The Sultanate of Oman is located in the southeastern region of the Gulf region with an area of 312,000 km². Oman has an indigenous population of 2.5 million, 70% live in urban areas, and 54.7% are between 15 and 64 years of age with a median age 19 years reflecting a younger population pyramid. The sex ratio is estimated to vary between 1.44 and 1.55 males/females, and 2.6% constitute the elderly aged 65 years and above. The percentage of the elderly in Oman is projected to reach 6.6% in 2025 and 10.5% in 2050.[3]

There have been only a few anecdotal reports on dementia from Oman. A seminal study conducted in The Royal Hospital, Muscat, Oman (2007), retrospectively reviewed the demographic and clinical spectra of 116 patients with probable dementia diagnosis. The diagnosis of dementia was made according to DSM-IV criteria and staged according to the Clinical Dementia Rating scale. Alzheimer’s disease was observed to be the most common dementia subtype (52.6%), while 24.1% had vascular dementia and 9.5% constituted frontotemporal lobar degeneration. Early onset dementia was seen in 45%, and potentially reversible dementia constituted 8.6%.[4]

In a similar vein, the Oman Geriatric Society (2018) cited that the number of people with Alzheimer’s disease is on the rise and in their clinic alone, as many as 3000 cases are reported from different governorates. Moreover, around 5% of people aged 65 and above have dementia, particularly Alzheimer’s disease, although it is caused by increasing age due to biological brain changes along with other risk factors such as environmental and genetics.[5]

Oman’s health system is currently transitioning from a focus on communicable diseases to addressing the increasing burden of noncommunicable diseases (NCDs), which include neurodegenerative disorders like Alzheimer’s disease. With lifestyle changes and increased life expectancy, conditions such as hypertension, diabetes, and obesity remain key risk factors for cognitive decline. The government’s strategy emphasizes early screening, preventive measures, and integrated care approaches to manage these conditions, highlighting the need for enhanced medical education on dementia-related care. (Oman Health Vision 2050).[6]

The Oman health vision 2050 recognizes elderly care as a priority and proposed the establishment of specialized healthcare services tailored to older adults, especially those affected by dementia and Alzheimer’s disease. It recommended the integration of medical and social services to ensure that the elderly remain independent and active within their communities. The plan emphasized the importance of training healthcare professionals, including medical students, in geriatric and dementia care to meet the future needs of the aging population. Public awareness initiatives were also highlighted as crucial for reducing stigma and improving the quality of life for individuals with dementia and their caregivers.

The increasing prevalence of dementia requires a simultaneous increase in the knowledge and competence of medical students toward timing of diagnosis, implementation of intervention, and quality of care, which impact overall patient outcomes.[6] Increased knowledge among them reduces stigma, increases patient quality of life, and reduces caregiver burden, and the converse is also true.[7]

Awareness is a reflective measure of perception of a group on a given aspect of one’s situation, functioning, or performance, or the resulting implications.[8] Several studies have monitored the knowledge and attitude toward Alzheimer’s disease. Some studies showed that only 15.7% of participants knew the risk factors for Alzheimer’s disease and 55.7% were not sure whether to share a diagnosis of Alzheimer’s disease with the patient.[9] Other studies have demonstrated that people do not consider dementia as a health priority.[10]

To the best of our knowledge, there is no existing literature that provides information on the knowledge, attitudes, and awareness of medical students regarding dementia and Alzheimer’s disease in Oman. This study aims to address the critical gap in understanding knowledge, attitudes, and practices regarding dementia among caregivers and healthcare professionals. Given the increasing prevalence of dementia globally, it is essential to assess how well these key stakeholders comprehend the condition, its implications, and the best practices for care. This research is vital for developing targeted educational programs and interventions that can improve the quality of care for individuals living with dementia. By exploring the varying levels of knowledge and attitudes toward dementia, we can identify areas for improvement and support caregivers in providing compassionate and informed care. Ultimately, this study seeks to enhance the overall wellbeing of both patients and caregivers, fostering a more informed community capable of addressing the challenges posed by dementia in the region [Figure 1].

Figure 1.

Conceptual framework of KAP aligned with Oman vision 2050

Materials and Methods

Study design and setting

The current cross-sectional survey targeted medical students. It aimed to assess the knowledge, awareness, and attitude of such individuals toward AD and dementia.

Study participants and sampling

A summary of the purpose of the study and informed consent were provided to the respondents on the front page of the questionnaire. Participants were assured that their participation was voluntary and anonymous. Access to the questionnaire was allowed only to participants who provided their consent by checking a box, made for this purpose, on the questionnaire. A total of 128 first-year medical students of the College of Medicine, National University were administered this questionnaire.

The survey consisted of two sections. The first section was related to general characteristic data, including information about sociodemographic characteristics (age, sex, marital status, transportation, socioeconomic status, and living during school years).

Participants were Omani female and male students aged between 18 and 30 years, and without psychiatric and/or chronic physiological disease or physical appearance-related disease. To estimate the sample size, we used the formula N = Z²P (1 − P)/d2 and we used a convenient sampling method for data collection.

Here:

• N = Required sample size

• Z = Z-score (standard normal variate) at a given confidence level

  • For 95% confidence level, Z = 1.96

  • For 90% confidence level, Z = 1.645

• P = Expected prevalence or proportion of the characteristic in the population (from previous studies or pilot study). If unknown, use 50% (0.5) for maximum variability.

• d = Margin of error (acceptable precision level, e.g., 5% = 0.05, 3% =0.03). The sample size turned out to be approximately N = 127 among the first-year MD medical students at COMHS, NU.

Data collection tool and technique

A short, online, self-contained survey in English was designed by the authors in collaboration with local and international researchers in the field of neurodegenerative diseases. We also adapted components from the published and previously tested Alzheimer’s Disease Knowledge Scale (ADKS),[11] the Alzheimer’s Disease Awareness Scale (ADAS),[12] and the Dementia Attitudes Scale (DAS),[13] in addition to incorporating questions to specifically assess the needs of healthcare practitioners in the region. The structured questionnaire (Supplementary Material) contained questions to record sociodemographic data including participant’s age, occupation, and their primary country of practice/study/work, questions to assess their experience in caring for elderly and people with AD, and whether they had any recent participation in AD or dementia-related educational training, including webinars, training courses, or grand rounds. Additionally, the main questionnaire consisted of seven questions to assess knowledge, nine questions to assess awareness/attitude, and five miscellaneous questions to assess awareness of the pathophysiology and scope of new treatments for dementia. In the 21 questions assessing the main outcome of knowledge, attitude, or awareness, participants selected answers based on a five-point Likert scale ranging from “strongly disagree” to” strongly agree” or from “not at all aware” to “extremely aware”. An overall index of knowledge was calculated by summing up the correct answers.

Ethical consideration

This study was approved by the local Ethics and Biosafety Committee of the College of Medicine and Health Sciences, National University of Science and Technology, Oman, according to intent and requirements of the Helsinki Declaration of Ethics (NU/COMHS/EBC006/2025).

Data analysis

Data analysis was performed using the Software Statistical Package for the Social Science (SPSS) version 22.0. Variables used to measure the general characteristics of the study sample were summarized by frequency and percentages. The questionnaire had three groups of questions on knowledge, attitude, and perception which were analyzed individually. The comparison between the groups’ means was conducted using the student and analysis of variance (ANOVA) tests. Results of Linear Regression Analysis indicates that knowledge (R² = 0.538) and perceptions (R² = 0.502) of participants are moderate predictors to the appraisal of Alzheimer’s disease among participants, while attitudes (R² = 0.671) toward the condition is a high predictor for the same. All statistical tests were conducted at a significance level alpha = 0.05.

Results

127 students participated in the study. 82.7% were females (n = 105) and 17.3% (n = 22) were males.

The average age of participants was 19.30 years (SD = 0.769). 74.6% of participants hailed from urban regions and 25.4% from rural regions. Currently, 42.5% of participants stay with their families, 42.5% stay on-campus/in the college hostel, and 15% in hostels outside the college campus. 91.2% of students were satisfied with their family income, while 8.8% were dissatisfied. 51.2% of students come from big families, and 48.8% from small families [Figure 2 and Table 1].

Figure 2.

Histogram Showing Frequency of participants responses

Table 1.

Sociodemographic profile of the participants

Variables		Category		n (%)
Gender		Female		106 (82.7%)
		Male		22 (17.3%)
Age (in years)		Mean (SD)		19.30 (0.77)
Region of Origin		Urban		95 (74.6%)
		Rural		32 (25.4%)
Current Living Arrangement		With family		54 (42.5%)
		On-campus/college hostel		54 (42.5%)
		Hostel outside college campus		19 (15.0%)
Satisfaction with Family Income		Satisfied		116 (91.2%)
		Dissatisfied		11 (8.8%)
Family Type		Big family		65 (51.2%)
		Small family		62 (48.8%)

Cronbach’s Alpha (0.535) indicates adequate reliability for the test items utilized. As shown in the figure, results of the Shapiro–Wilk test indicate that participants’ responses were not normally distributed (P=0.000)

Cronbach’s Alpha (0.535) indicates adequate reliability for the test items utilized. As shown in the figure, results of the Shapiro–Wilk test indicate that participants’ responses were not normally distributed (P = 0.000).

The responses of participants across the various domains of the survey questionnaire are shown in the figures below:

Results of the Mann–Whitney test show no significant differences in the responses of participants in relation to gender, place/type of residence, family income, and family size. Results of Spearman correlation indicated significance of survey items in relation to the total score.

The survey items were divided into the following three domains:

D1 (Knowledge): Q1, Q2, Q5, Q12, Q13, Q15, Q16

D2 (Attitude): Q3, Q4, Q6, Q7, Q8, Q9, Q10, Q11, Q14

D3 (Perceptions): Q17, Q18, Q19, Q20, Q21

Results of Spearman’s analysis indicate significant inter-domain correlation as shown in the Table 2:

Table 2.

Spearman’s correlation coefficients between total scores and subdomains of knowledge (D1), awareness (D2), and practice (D3) related to dementia

		Total score		D1		D2		D3
Total score
Correlation coefficient		1.000		0.711**		0.748**		0.659**
Sig. (2-tailed)		–		0.000		0.000		0.000
D1
Correlation coefficient		0.711**		1.000		0.279**		0.377**
Sig. (2-tailed)		0.000		–		0.001		0.000
D2
Correlation coefficient		0.748**		0.279**		1.000		0.323**
Sig. (2-tailed)		0.000		0.001		–		0.000
D3
Correlation coefficient		0.659**		0.377**		0.323**		1.000
Sig. (2-tailed)		0.000		0.000		0.000		–

The Spearman’s correlation analysis revealed statistically significant inter-domain relationships among knowledge (D1), awareness (D2), and practice (D3) concerning dementia. Knowledge (D1) demonstrated a moderate positive correlation with awareness (D2) (ρ=0.279, P<0.01) and practice (D3) (ρ=0.377, P<0.01), indicating that higher dementia-related knowledge is associated with improved awareness and more appropriate practices. Awareness (D2) was also positively correlated with practice (D3) (ρ=0.323, P<0.01)

Knowledge regarding Alzheimer’s Disease and Dementia

In our sample, 54.4% of the respondents had correctly identified that loss of memory and forgetting names, appointments, and task repetition in the elderly need medical attention. Approximately half of the students, 47.6%, disagreed that Alzheimer’s disease could be caused by black magic or evil eye. Three fourths of the respondents, 76.6%, believed that early diagnosis of Alzheimer’s could have a better response. As a proof of being millennials, 67.4% of the students had believed that Artificial Intelligence could be helpful in the process of diagnosis and management of Alzheimer’s disease. Most of the students, 89.1%, believed that lifestyle can shape the brain.

Attitude toward Alzheimer’s Disease and Dementia

The opinions that the respondents held regarding Alzheimer’s disease and dementia are depicted in Figure 6 (Attitude). As a whole, 53.1% of participants were against hiding diagnoses and advocated for transparency. On the other hand, 73.4% of participants expressed strong disapproval of socially isolating Alzheimer’s disease patients to prevent them from experiencing personal embarrassment. On the other hand, there was a wide range of opinions on alternative medicine, with 37.5% of respondents expressing neutrality. In total, 70.7% of survey participants expressed significant backing for the legal safeguarding of patients’ rights. When asked if they would feel embarrassed if someone in their direct family received an Alzheimer’s diagnosis, 79% of individuals denied this. However, a far higher percentage of 81.8% said they accepted the diagnosis as true. A total of 64.5% of respondents who took part in the study said that having significant support for research was extremely important. In addition, 53.1% of participants are in support of home care as opposed to institutional care, and 73.2% are in favor of professional education.

Figure 6.

Distribution of Participant Responses to Attitude-Based Survey Items on Dementia

Perception regarding Alzheimer’s Disease and Dementia

The perceptions of the respondents on Alzheimer’s disease and dementia are depicted in the graph titled “Perception.” Among those who participated in the survey, 56.7% acknowledge the possibility that certain foods, such as fish, leafy greens, and berries, could reduce the chance of developing Alzheimer’s disease. There is a moderate tendency toward belief in the existence of traditional remedies in Oman (45.3%), according to the data, which indicate that there is a mixed assessment of the availability of traditional remedies in Oman. The perception of alternative therapies, such as aromatherapy, music, and dance, was met with a mixed response, with a little tendency toward its approval at the surface level. In addition, a significant number of respondents, which accounted for 78.1% of the total, expressed a high level of trust in the availability of pharmaceutical treatments for Alzheimer’s disease.

Discussion

Knowledge regarding Alzheimer’s disease and dementia

The findings revealed that memory loss, forgetfulness about names and appointments, and repetitive behaviors are all patterns for which older adults should pursue medical evaluation, as indicated by 54.4% of respondents who answered accurately. This is a good sign, but it also shows that things could be better. This level of awareness is in line with earlier studies that found people do not always recognize the signs of AD. For example, Hakami et al.[14] found that while memory loss was easy for many people to spot as a sign of AD, other cognitive and behavioral signs were not as easy to spot. The writers stressed how important it is to keep teaching people about all the different signs and symptoms of AD so that they can be found and treated early. It is thought that making people aware of and knowing the risk factors for Alzheimer’s disease is important for taking care of patients.[15] In a similar vein, researchers have looked at many studies and found that most of the people who took part knew only a fair to reasonable amount about AD and dementia. However, they knew a lot about the signs and symptoms of AD, as well as the risk factors and other parts of the disease. A study by Paul et al.[16] also found that people knew a fair amount about AD and dementia [Figures 3 and 4].

Figure 3.

D1- Scatter plot showing Dementia Knowledge score Vs the total score

Figure 4.

Distribution of Participant Responses to Knowledge-Based Survey Items on Dementia

The finding indicating that 47.6% of students refuted the notion that AD may be attributed to black magic or the evil eye is significant. Although it is encouraging that nearly half of the respondents dismiss supernatural hypotheses, it indicates that a substantial segment of the sample may possess misunderstandings regarding the origin of Alzheimer’s disease. This discovery aligns with the research conducted by Siddiqui et al., which indicated that cultural beliefs and myths regarding dementia might profoundly influence help-seeking behaviors and adherence to treatment.[17] These may encompass beliefs that dementia is a retribution for immoral actions,[18] or a ‘divine act’ or supernatural intervention/curse.[19]

The significant proportion (76.6%) of respondents who believe that early detection of Alzheimer’s disease could result in improved outcomes is promising and consistent with contemporary medical knowledge. The findings are corroborated by the research conducted by Paul et al.,[16] wherein the majority of participants concurred that early detection of Alzheimer’s disease could lead to improved treatment outcomes. This knowledge is essential as early diagnosis and intervention have demonstrated improvements in outcomes and quality of life for patients with Alzheimer’s disease.[20] The authors emphasized that early diagnosis facilitates prompt access to medicines and support services and enables patients and families to prepare for the future. Sixty-seven-point four percent of students believe that Artificial Intelligence (AI) may assist in the diagnosis and management of AD, indicating an awareness of advancing technology in healthcare. A study conducted by Paul et al. yielded analogous findings, indicating that respondents perceived artificial intelligence as potentially advantageous in neurodegenerative disorders. This viewpoint is corroborated by recent developments in AI applications for Alzheimer’s disease. A study by Kale et al.[21] revealed that machine learning algorithms may accurately forecast Alzheimer’s disease development utilizing neuroimaging data. The authors proposed that AI may improve early detection and individualized treatment approaches for Alzheimer’s disease.

The predominant conviction (89.1%) that lifestyle influences brain function is consistent with contemporary scientific data. Research conducted by Paul et al. revealed that a significant majority of respondents (86.5%) assert that lifestyle influences brain development. This understanding is essential for public health activities focused on dementia prevention. Livingston et al. (2020) conducted a thorough review that revealed various modifiable risk factors for dementia, such as education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and limited social interaction. The scientists projected that mitigating these factors might potentially avert or postpone up to 40% of dementia occurrences.[22]

Attitude toward Alzheimer’s disease and dementia

Over half of participants (53.1%) opposed concealing the diagnosis, advocating for transparency. This corresponds with recent studies highlighting the significance of disclosure in dementia care.[16] Yang et al.[23] discovered that the majority of participants favored that patients better be informed of their diagnosis as it facilitates improved planning and decision-making. This tendency toward transparency signifies a departure from the previous practice of obscuring dementia diagnoses, sometimes influenced by stigma and misconceptions surrounding the disease.[24] The significant resistance to the social isolation of Alzheimer’s disease patients (73.4%) is promising and aligns with contemporary best practices in dementia treatment. The findings align with a previous study suggesting that Alzheimer’s disease sufferers should eschew social engagements to prevent personal embarrassment.[25] In a similar vein, researchers emphasized the significance of social participation for individuals with dementia, observing its beneficial impact on quality of life and cognitive performance.[26] This sentiment among respondents indicates an increasing recognition of the advantages of social inclusion for those with Alzheimer’s disease. The diverse opinions on alternative medicine, with 37.5% remaining neutral, illustrate the intricate dynamics of complementary and alternative medicine (CAM) in dementia treatment. Wang et al.[26] performed a systematic evaluation of nonpharmacological therapy in Alzheimer’s disease and identified evidence supporting certain approaches, while emphasizing the necessity for further rigorous research in other domains [Figures 5 and 6].

Figure 5.

D2 -Scatter plot showing Dementia Attitude score Vs the total score

The neutral position of numerous responders may suggest a cautious attitude toward CAM, admitting some advantages while understanding the necessity for further data. The robust endorsement for the legal safeguarding of patient rights (65%) corresponds with the increasing focus on person-centered care in dementia. The findings are supported by the study in which participants asserted that when a patient with Alzheimer’s disease encounters challenges in executing daily activities, the legal system should safeguard the patient’s rights. Serbser et al.[27] underscored the significance of honoring the autonomy and rights of individuals with dementia, notwithstanding the deterioration of their cognitive faculties. This disposition among participants indicates an acknowledgment of the ethical obligations in dementia care.

The substantial amount of individuals (77.9%) who reported not feeling embarrassed by a close relative’s diagnosis of Alzheimer’s disease, along with the greater percentage (81.8%) who would accept the diagnosis, suggests a decline in the stigma surrounding dementia.[28] The findings are backed up by the research, wherein most participants refuted feelings of embarrassment over a close family’s diagnosis of AD, and an even larger percentage indicated they would not reject an AD diagnosis for a relative. Rosin et al.[8] discovered that public awareness of Alzheimer’s disease correlated with less stigma, indicating that educational initiatives may be fostering these favorable perceptions.

The robust support for research (84.2%) indicates public acknowledgment of the significance of scientific endeavors to help understand and address AD. This corresponds with the findings of Akincigil et al.,[29] who indicated substantial public support for supporting dementia research. Analogous findings were revealed, revealing that a significant proportion of respondents had a belief in the potential of dementia research to enhance outcomes for patients, families, and providers. The inclination for home care rather than institutional care (53.1%) aligns with international trends in dementia care. Joo et al.[30] observed that family caring constitutes the predominant form of care for individuals with dementia globally, frequently influenced by cultural inclinations and economic considerations. The endorsement of professional education (53.5%) highlights the acknowledgment of the necessity for specialized training in dementia care.[29] Van Den Brink et al.[31] underscored the necessity of dementia-focused education for healthcare personnel to enhance care quality and outcomes for individuals with dementia. The findings indicate predominantly favorable attitudes toward Alzheimer’s disease and dementia, with robust endorsement for transparency, social inclusion, research, and patient rights. Nevertheless, several domains exhibit greater division of opinion, particularly with alternative medicine, suggesting opportunities for enhanced education and study.

Perception regarding Alzheimer’s disease and dementia

The findings offer significant insights into the attitudes of AD and dementia within the investigated demographic. A majority of respondents (56.7%) acknowledging the potential influence of nutrition on mitigating Alzheimer’s risk is consistent with existing scientific findings. This knowledge is promising as dietary elements have been progressively associated with cognitive health and the risk of dementia. Van den Brink et al.[31] conducted a thorough evaluation that emphasized the efficacy of specific dietary patterns, notably the Mediterranean and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diets, in mitigating the risk of cognitive decline and Alzheimer’s disease. These diets prioritize the intake of berries, leafy greens, and fish, as explicitly indicated in the survey findings. Researchers observed that compliance with these dietary patterns correlated with a 30–35% reduction in the risk of cognitive impairment in observational studies [Figures 7 and 8].[31]

Figure 7.

D3 Scatter plot showing Demantia Perception score Vs the total score

Figure 8.

Distribution of Participant Responses to Practice-Based Survey Items on Dementia

The mixed impression of local traditional treatments, with a modest inclination toward their availability (45.3%), illustrates the intricate relationship between traditional and modern medicine in the context of Alzheimer’s care. This discovery aligns with the research conducted by Thawabteh et al.,[32] which examined the application of conventional and alternative therapies for dementia in several cultures. The prevalence of traditional treatments was observed in numerous non-Western civilizations, frequently existing alongside contemporary medical practices.[33] The authors underscored the necessity for healthcare personnel to recognize and accommodate these cultural norms while formulating treatment plans for dementia patients. In a similar vein, several researchers have emphasized on the effectiveness of natural remedies in memory impairments and AD. Babashpour-Asl et al.’s[34] review highlights the snowdrop herb from the Galanthus genus of the Amaryllidaceae family as a natural source of galantamine, an alkaloid with significant anticholinesterase properties used in Alzheimer’s disease therapy. The mixed attitude on the acceptance of alternative therapies such as aromatherapy, music, and dance, with a little inclination toward acceptance, aligns with the increasing body of research on nonpharmacological interventions for Alzheimer’s disease. Evidence has been found endorsing the efficacy of music therapy for behavioral symptoms and cognitive stimulation therapy for cognitive function. However, the authors found that the evidence level for numerous alternative medicines is inadequate, potentially clarifying the varied perceptions identified in the survey.[35]

The significant percentage of respondents (78.1%) expressing robust trust in the accessibility of medical therapies for Alzheimer’s disease is remarkable, particularly in light of recent advancements in AD medicines. This view may be affected by recent endorsements of disease-modifying therapies. Cummings et al.[36] examined the FDA approval of aducanumab, the first disease-modifying drug for Alzheimer’s disease, and its prospective influence on the treatment paradigm for Alzheimer’s disease. The authors emphasized that although these novel medicines present promise, they also include obstacles regarding administration, adverse effects, and the preparedness of the healthcare system. Nonetheless, it is crucial to recognize that this elevated confidence may not entirely correspond with the present condition of Alzheimer’s disease treatments. The Alzheimer’s Association[37] indicates that although novel therapies such as lecanemab and donanemab demonstrate potential in mitigating cognitive loss in early Alzheimer’s disease, they do not constitute cures and are useful solely for a limited group of individuals in the initial stages of the condition.

This study addresses a critical and timely topic of Alzheimer’s disease and dementia, which are areas of growing concern globally and particularly relevant to Oman considering the country’s health vision for future healthcare providers. By evaluating knowledge, attitudes, and perceptions simultaneously, the study offers a holistic picture of students’ preparedness and beliefs regarding Alzheimer’s disease and dementia. The study included culturally relevant items (e.g., belief in black magic, traditional remedies in Oman), which helped in contextualizing student perceptions within their sociocultural setting. A significant proportion of students acknowledged the potential of AI in diagnosis and treatment, suggesting openness to technological integration in medicine.

Study limitations

The study has several limitations. First, the cross-sectional study design was used in this research, so it could not establish causal relationship between the independent variables and the AD knowledge score. Second, the sample size was low since only the first-year medical students were involved. Third, there could have been comparison between the first years of medical graduates and the final-year medical students to see whether there are any significant differences. Fourth, it should be remarked that this study used a convenience sampling method and use of such a convenience sample might limit capability to generalize findings.

Conclusion

The results indicate a well-informed understanding of Alzheimer’s disease and dementia within the studied community, especially concerning dietary influences and the possibilities of medicinal interventions. The divergent opinions on standard and alternative medicines suggest that additional education and study could be advantageous. As Alzheimer’s disease research progresses, continuous public education initiatives will be essential to align attitudes with the most recent scientific findings and accessible treatment alternatives.

The findings of this study reflect a relatively sound understanding of Alzheimer’s disease and dementia among medical graduates, particularly regarding modifiable risk factors and pharmacological interventions. However, variations in perceptions around standard versus alternative treatments highlight the need for more structured educational efforts.

Given the Sultanate of Oman’s projected demographic shift marked by a significant increase in the elderly population and the growing burden of noncommunicable diseases, including neurodegenerative disorders, these insights are especially pertinent. In alignment with the Health Vision 2050, which prioritizes equitable, evidence-based, and community-oriented health services, it is imperative to enhance the medical curriculum and continuing education in dementia care among medical students.

Furthermore, the Vision’s emphasis on integrated primary health care and human resource development underscores the need for a healthcare workforce equipped not only with clinical knowledge but also with attitudes conducive to holistic, person-centered care. Public and professional awareness campaigns must therefore evolve in parallel with scientific advancements to ensure policy-informed, culturally competent, and sustainable dementia care strategies across Oman.

Future directions

Future research should consider larger samples including different years from the same medical college to see the difference based on the number of years of medical education and its influence on the knowledge, attitude, and practice. Comparison among multiple medical colleges within Oman and across different regions or countries would improve generalizability and explore geographical or cultural variations in knowledge, attitudes, and practices. A longitudinal design could track changes in knowledge and attitudes over time, particularly as students’ progress through their medical education and clinical rotations. Incorporating qualitative methods (e.g., focus groups or interviews) would provide richer, more clearer insights into students’ beliefs, misconceptions, and emotional responses related to Alzheimer’s disease and dementia. Future research may also explore the impact of incorporating dementia-related content into medical curricula and how this aligns with national health priorities or WHO dementia action plans.

Author’s contributions

The study protocol is a student led project approves by the ethics committee of the College of Medicine and Health Sciences, NU. APR, MS and MA were involved in the study design and developed the framework of the work. The students MYAS and YIAM helped in the data collection and wrote the first draft of this manuscript. RMB, RV and MA reviewed and worked on the subsequent drafts of the protocol and manuscript. All authors approved the final manuscript.

Abbreviations

• AD: Alzheimer’s disease,

• ADAS: Alzheimer’s Disease Awareness Scale,

• ADKS: Alzheimer’s Disease Knowledge Scale,

• CAM: Complementary and Alternative Medicine

• DAS: Dementia Attitude Scale,

• EM: Eastern Mediterranean,

• NCD: Noncommunicable diseases.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

No funding was received for this study.