Fei-Fei Hu1, Gui-Rong Cheng1, Dan Liu1, Qian Liu2, Xu-Guang Gan1, Lin Li1, Xiao-Dan Wang3, Bo Zhang1, Li-Na An1, Cong Chen1, Ming-Jun Zou1, Lang Xu1, Yang-Ming Ou1, Yu-Shan Chen1, Jin-Quan Li1, Zhen Wei1, Yue-Yi Wang1, Qiong Wu1, Xing-Xing Chen1, Xi-Fei Yang4, Qing-Ming Wu5, Lei Feng6, Jing-Jing Zhang1, Heng Xu1, Ya-Fu Yu1, Meng-Liu Yang1, Jin Qian1, Peng-Fei Lian1, Li-Yan Fu1, Ting-Ting Duan1, Yuan Tian1, Xi Cheng1, Xin-Wen Li1, Pin-Ting Yan1, Guowei Huang2, Hongxin Dong1, Yong Ji7, Yan Zeng8. 1. Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, West Huangjiahu Road, Hongshan District, Wuhan, 430065, China. 2. Department of Nutrition and Food Science, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China. 3. Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, 300350, China. 4. Key Laboratory of Modern Toxicology of Shenzhen, Shenzhen Center for Disease Control and Prevention, No. 8, Longyuan Road, Nanshan District, Shenzhen, 518055, China. 5. Tianyou Hospital affiliated to Wuhan University of Science and Technology, Wuhan, China. 6. Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 7. Department of Neurology, Beijing Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, 100070, China. jiyongusa@126.com. 8. Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, West Huangjiahu Road, Hongshan District, Wuhan, 430065, China. zengyan68@wust.edu.cn.
Abstract
BACKGROUND: The prevalence of dementia in China, particularly in rural areas, is consistently increasing; however, research on population-attributable fractions (PAFs) of risk factors for dementia is scarce. METHODS: We conducted a cross-sectional survey, namely, the China Multicentre Dementia Survey (CMDS) in selected rural and urban areas from 2018 to 2020. We performed face-to-face interviews and neuropsychological and clinical assessments to reach a consensus on dementia diagnosis. Prevalence and weighted PAFs of eight modifiable risk factors (six classical: less childhood education, hearing impairment, depression, physical inactivity, diabetes, and social isolation, and two novels: olfactory decline and being unmarried) for all-cause dementia were estimated. RESULTS: Overall, CMDS included 17,589 respondents aged ≥ 65 years, 55.6% of whom were rural residents. The age- and sex-adjusted prevalence for all-cause dementia was 9.11% (95% CI 8.96-9.26), 5.19% (5.07-5.31), and 11.98% (11.8-12.15) in the whole, urban, and rural areas of China, respectively. Further, the overall weighted PAFs of the eight potentially modifiable risk factors were 53.72% (95% CI 52.73-54.71), 50.64% (49.4-51.89), and 56.54% (55.62-57.46) in the whole, urban, and rural areas of China, respectively. The eight risk factors' prevalence differed between rural and urban areas. Lower childhood education (PAF: 13.92%) and physical inactivity (16.99%) were primary risk factors in rural and urban areas, respectively. CONCLUSIONS: The substantial urban-rural disparities in the prevalence of dementia and its risk factors exist, suggesting the requirement of resident-specific dementia-prevention strategies.
BACKGROUND: The prevalence of dementia in China, particularly in rural areas, is consistently increasing; however, research on population-attributable fractions (PAFs) of risk factors for dementia is scarce. METHODS: We conducted a cross-sectional survey, namely, the China Multicentre Dementia Survey (CMDS) in selected rural and urban areas from 2018 to 2020. We performed face-to-face interviews and neuropsychological and clinical assessments to reach a consensus on dementia diagnosis. Prevalence and weighted PAFs of eight modifiable risk factors (six classical: less childhood education, hearing impairment, depression, physical inactivity, diabetes, and social isolation, and two novels: olfactory decline and being unmarried) for all-cause dementia were estimated. RESULTS: Overall, CMDS included 17,589 respondents aged ≥ 65 years, 55.6% of whom were rural residents. The age- and sex-adjusted prevalence for all-cause dementia was 9.11% (95% CI 8.96-9.26), 5.19% (5.07-5.31), and 11.98% (11.8-12.15) in the whole, urban, and rural areas of China, respectively. Further, the overall weighted PAFs of the eight potentially modifiable risk factors were 53.72% (95% CI 52.73-54.71), 50.64% (49.4-51.89), and 56.54% (55.62-57.46) in the whole, urban, and rural areas of China, respectively. The eight risk factors' prevalence differed between rural and urban areas. Lower childhood education (PAF: 13.92%) and physical inactivity (16.99%) were primary risk factors in rural and urban areas, respectively. CONCLUSIONS: The substantial urban-rural disparities in the prevalence of dementia and its risk factors exist, suggesting the requirement of resident-specific dementia-prevention strategies.
Authors: Gill Livingston; Andrew Sommerlad; Vasiliki Orgeta; Sergi G Costafreda; Jonathan Huntley; David Ames; Clive Ballard; Sube Banerjee; Alistair Burns; Jiska Cohen-Mansfield; Claudia Cooper; Nick Fox; Laura N Gitlin; Robert Howard; Helen C Kales; Eric B Larson; Karen Ritchie; Kenneth Rockwood; Elizabeth L Sampson; Quincy Samus; Lon S Schneider; Geir Selbæk; Linda Teri; Naaheed Mukadam Journal: Lancet Date: 2017-07-20 Impact factor: 202.731
Authors: Gill Livingston; Jonathan Huntley; Andrew Sommerlad; David Ames; Clive Ballard; Sube Banerjee; Carol Brayne; Alistair Burns; Jiska Cohen-Mansfield; Claudia Cooper; Sergi G Costafreda; Amit Dias; Nick Fox; Laura N Gitlin; Robert Howard; Helen C Kales; Mika Kivimäki; Eric B Larson; Adesola Ogunniyi; Vasiliki Orgeta; Karen Ritchie; Kenneth Rockwood; Elizabeth L Sampson; Quincy Samus; Lon S Schneider; Geir Selbæk; Linda Teri; Naaheed Mukadam Journal: Lancet Date: 2020-07-30 Impact factor: 79.321