Abstract
BackgroundTo explore the prevalence and inequality of cognitive impairment among older adults in Macau and the contributions of influencing factors to inequality in cognitive impairment.MethodsThe Montreal Cognitive Assessment (MoCA) was used to measure the prevalence of cognitive impairment. Socioeconomic status scores were used to describe economic level of the subjects. The concentration index was applied to measure the inequality of cognitive impairment associated with socioeconomic status (SES) and decomposed into its influencing factors.ResultsThe prevalence of cognitive impairment was 44.35% in Macau. The concentration index of cognitive impairment among the elderly was −0.165 (95% CI: −0.232 to −0.098), indicating that the prevalence of cognitive impairment was concentrated in households with poor SES. Older age, poor SES, long or short sleep duration, other marital status, poor appetite, no tea/coffee drinking, no religious belief, and depression contributed positively to the inequality of cognitive impairment. Among these factors, SES made the largest contribution to inequality, accounting for 76.74%.ConclusionIn Macau, the prevalence of cognitive impairment among people aged 65 years and older is concentrated among those who are in poor economic conditions. Reducing the gap between the rich and the poor at the source, increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.
Highlights
With increasing life expectancy and declining fertility, China has experienced rapid aging over the past few decades, and at a significantly faster rate than most countries (Fang et al, 2020)
The aging population has led to a higher prevalence of chronic diseases and dysfunctions among older adults, with more than 100 million older adults in China suffering from chronic non-communicable diseases in 2013 (Wang and Chen, 2014)
A total of 345 subjects were investigated in this study, and the prevalence of cognitive impairment was 44.35%
Summary
With increasing life expectancy and declining fertility, China has experienced rapid aging over the past few decades, and at a significantly faster rate than most countries (Fang et al, 2020). There are 264.02 million people in China aged 60 years and above, accounting for 18.70% the total population, by the end of 2020 (Tang et al, 2021). The aging population has led to a higher prevalence of chronic diseases and dysfunctions among older adults, with more than 100 million older adults in China suffering from chronic non-communicable diseases in 2013 (Wang and Chen, 2014). More than 37 million older people have physical impairments (Miao et al, 2019). As a chronic non-communicable disease, is becoming an important public health problem in China. Dementia is the most severe stage of cognitive impairment and is the leading cause of disability in people over 60 years of age worldwide, including China (Clay et al, 2019). To explore the prevalence and inequality of cognitive impairment among older adults in Macau and the contributions of influencing factors to inequality in cognitive impairment
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