Abstract
Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia.
Highlights
The study of the prevalence of cognitive impairment is essential since it is a common condition in elderly and has a complex relationship with more serious conditions, such as dementia or depression (Steffens et al, 2014).Previous research on the prevalence of age-related cognitive impairment shows considerable variability, due to the different diagnostic criteria used, the degree of severity of clinicalCognitive Impairment and Degree of Urbanization and Occupation manifestations, and the age range covered (Brayne et al, 1998; Rait et al, 2005)
Prevalence of Cognitive Impairment According to the Degree of Urbanization
A significant association between lifetime longest-held occupations skill level and better cognitive functioning in later life
Summary
The study of the prevalence of cognitive impairment is essential since it is a common condition in elderly and has a complex relationship with more serious conditions, such as dementia or depression (Steffens et al, 2014).Previous research on the prevalence of age-related cognitive impairment shows considerable variability, due to the different diagnostic criteria used, the degree of severity of clinicalCognitive Impairment and Degree of Urbanization and Occupation manifestations, and the age range covered (Brayne et al, 1998; Rait et al, 2005). Besides the well-recognized age and education effects, patterns of cognitive impairment have been shown to be determined by geographical/rurality variables. The prevalence of cognitive impairment has been shown to be higher in rural than in urban populations (Martín Lesende et al, 2001; Nunes et al, 2010). The better functional-cognitive status observed in the urban environment has been, in general, associated with differences in lifestyle and greater accessibility and availability of the social-health care resources (Martín Lesende et al, 2001). Finding possible differences in the risk of cognitive impairment among geographic areas may be important in the allocation of public resources in rural and urban areas (Keefover et al, 1996); the link between the degree of urbanization (DEGURBA) and cognitive impairment has not been widely studied
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