Abstract
Large households/families may create more happiness and offer more comprehensive healthcare among the members. We correlated household size to dementia mortality rate at population level for analysing its protecting role against dementia mortality. This is a retrospective cross-sectional study. Dementia specific mortality rates of the 183 member states of World Health Organization were calculated and matched with the respective country data on household size, Gross Domestic Product (GDP), urban population and ageing. Scatter plots were produced to explore and visualize the correlations between household size and dementia mortality rates. Pearson's and nonparametric correlations were used to evaluate the strength and direction of the associations between household size and all other variables. Partial correlation of Pearson's approach was used to identify that household size protects against dementia regardless of the competing effects from ageing, GDP and urbanization. Multiple regression was used to identify significant predictors of dementia mortality. Household size was in a negative and moderately strong correlation (r = -0.6034, p < 0.001) with dementia mortality. This relationship was confirmed in both Pearson r (r = - 0.524, p<0.001) and nonparametric (rho = -0.579, p < 0.001) analyses. When we controlled for the contribution of ageing, socio-economic status and urban lifestyle in partial correlation analysis, large household was still in inverse and significant correlation to dementia mortality (r = -0.331, p <0.001). This suggested that, statistically, large household protect against dementia mortality regardless of the contributing effects of ageing, socio-economic status and urban lifestyle. Stepwise multiple regression analysis selected large household as the variable having the greatest contribution to dementia mortality with R2 = 0.263 while ageing was placed second increasing R2 to 0.259. GDP and urbanization were removed as having no statistically significant influence on dementia mortality. While acknowledging ageing, urban lifestyle and greater GDP associated with dementia mortality, this study suggested that, at population level, household size was another risk factor for dementia mortality. As part of dementia prevention, healthcare practitioners should encourage people to increase their positive interactions with persons from their neighbourhood or other fields where large household/family size is hard to achieve.
Highlights
Dementia is an umbrella neurological syndrome resulting from more than 100 brain disorders, most common of which include Alzheimer’s disease, vascular diseases, Lewy bodies, frontotemporal disease etc. [1, 2]
When we controlled for the contribution of ageing, socio-economic status and urban lifestyle in partial correlation analysis, large household was still in inverse and significant correlation to dementia mortality (r = −0.331, p
Urban lifestyle and greater Gross Domestic Product (GDP) associated with dementia mortality, this study suggested that, at population level, household size was another risk factor for dementia mortality
Summary
Dementia is an umbrella neurological syndrome resulting from more than 100 brain disorders, most common of which include Alzheimer’s disease, vascular diseases, Lewy bodies, frontotemporal disease etc. [1, 2]. It is estimated that 5–8% of general population aged 60 and over have been diagnosed with dementia in past years [2]. It has become one of the most common causes of dependency and disability among the elderly [1, 2]. Dementia produces an increasing societal burden resulting in a total economic costs of US$ 818 billion (1.1% of the world’s gross domestic product) in 2016 [2], which has been considered as the major challenging health issue in 21st century [3, 4]. Dementia patients and their families are subject to prejudice, and their life quality is affected [1]. We correlated household size to dementia mortality rate at population level for analysing its protecting role against dementia mortality
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