Abstract
Screening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence. In this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected through computerized random sampling from all administrative districts in Taiwan and were assessed using an in-person interview. We calculated the prevalence of MCI and dementia, with their risk factors examined using multivariable logistic regression. The prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68-8.69), 6.63% (95% CI, 6.62-6.63), and 4.46% (95% CI, 4.46-4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural:urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones. Significantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied by urbanization status. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.
Highlights
Dementia has become a global public health priority, as it is closely associated with considerable consequences, such as disability, mortality, and socioeconomic burden.[1,2] People with mild cognitive impairment (MCI) are recognized as a high-risk group for developing dementia.[3]
We explored the association between the degree of urbanization and the prevalence of dementia and MCI
Rural-urban Disparities in Mild Cognitive Impairment and Dementia urban differences in many aspects, such as lifestyle, education, and comorbidities, we examined whether MCI and dementia’s risk factors varied between urban and rural populations
Summary
Dementia has become a global public health priority, as it is closely associated with considerable consequences, such as disability, mortality, and socioeconomic burden.[1,2] People with mild cognitive impairment (MCI) are recognized as a high-risk group for developing dementia.[3]. Many previous studies have explored the role of urbanization in older adults’ risk of MCI4–7 and dementia.[7,8,9,10,11,12,13,14,15,16] these results were inconclusive. Data and methodological challenges remain in the research on urbanization with MCI and dementia. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence
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