Population-attributable fractions of risk factors for all-cause dementia in China rural and urban areas: a cross-sectional study

Fei fei Hu, Gui rong Cheng, Dan Liu, Qian Liu, Xu guang Gan, Lin Li, Xiao dan Wang, Bo Zhang, Li na An, Cong Chen, Ming jun Zou, Lang Xu, Yang ming Ou, Yu shan Chen, Jin quan Li, Zhen Wei, Yue yi Wang, Qiong Wu, Xing xing Chen, Xi fei YangQing ming Wu, Lei Feng, Jing jing Zhang, Heng Xu, Ya fu Yu, Meng liu Yang, Jin Qian, Peng fei Lian, Li yan Fu, Ting ting Duan, Yuan Tian, Xi Cheng, Xin wen Li, Pin ting Yan, Guowei Huang, Hongxin Dong, Yong Ji, Yan Zeng*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalJournal of Neurology
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • China
  • Dementia
  • Population-attributable fractions
  • Risk factor

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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