A qualitative evaluation of older people’s perceptions towards optimal diet management in the context of antimicrobial resistance

TL;DR

This study explores how older people perceive diet in relation to antimicrobial resistance, finding that they lack awareness and motivation to change their diets for AMR management.

Contribution

The study identifies key themes in older adults' perceptions of diet and AMR, highlighting the need for public education and tailored dietary tools.

Findings

Older people show low awareness and motivation to change diets for AMR management.

Participants prefer independent diet strategies and value credible health advice.

Age-related barriers and a focus on general health over AMR were commonly reported.

Abstract

Antimicrobial Resistance (AMR) poses a significant global public health problem. The risk of developing a reservoir of antimicrobial resistant genes in the gut is reportedly higher with certain diets, rendering individual diet-related AMR management a largely untapped approach in AMR mitigation. As a vulnerable population, older people are at particular risk of poorer resistant infection outcomes. The aim of this study was to explore older people’s perceptions of diet and health factors surrounding AMR.

This was a qualitative study using semi-structured interviews. Purposive convenience sampling was used to recruit 17 members of the public who were aged 65 years and over and a basic questionnaire was used to collect demographic and health data. Interviews were conducted in-person in the UK South West region, over Microsoft Teams and via telephone. All interviews were recorded, transcribed and analysed thematically for trends and meaning.

Five key themes were identified: AMR lack of familiarity, a low motivation to change long-term diet to reduce AMR, life enjoyment, prioritising general diet behaviours in lieu of AMR management, age-related barriers to behavioural change and healthcare and public-led diet-related AMR management. A low awareness of AMR generally appeared to solidify apathy towards the subject and a reluctance to consider any long-term dietary change for the purpose of AMR management. Comparatively, the cohort held strong opinions towards diet as a means of maintaining health and health decision-making. Independent diet management strategies were preferable over group sessions with the credibility of advice deemed crucial.

The older public’s unfamiliarity with AMR, antibiotics and the influence of diet demonstrates an urgent need for public awareness and education as a preliminary and essential action. Shifting the focus of AMR from an individualistic problem to a collective issue where we need to minimise the harm to others should be considered to inspire public motivation towards this important public health issue. The development of a dietary-related AMR management tool that offers tailored and strategic advice to a public population who already exhibit an existing interest in general dietary health is further recommended.

The online version contains supplementary material available at 10.1186/s12889-025-25375-4.