Tang Hui-Dong, Zhou Yi, Gao Xiang, Liang Liang, Hou Miao-Miao, Qiao Yuan, Ma Jian-Fang, Chen Sheng-Di
Department of Neurology and Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
J Alzheimers Dis. 2016;49(4):917-25. doi: 10.3233/JAD-150748.
China is facing a continuously rising numbers of people with cognitive impairment (CI).
To investigate the prevalence and risk factors of CI among elderly people living in rural and urban communities.
We conducted a face-to-face survey of CI on 7,900 individuals aged 50 years or older meeting inclusion criteria in the Malu (rural community, n = 4,429) and Wuliqiao (urban community, n = 3,471) communities of Shanghai. The Mini-Mental State Examination (MMSE) was used to evaluate the cognitive function. Information on demographic features and potential risk factors for CI was collected during the interview. Multivariate logistic regression was performed to identify risk factors associated with CI.
Based on the education modified MMSE score, we identified 329 CI cases in rural community and 227 in urban community. The prevalence of CI was 7.43% in rural population and 6.54% in urban population (p = 0.13). In the urban population, risk of having CI was associated with age (OR = 1.04; 95% CI: 1.01-1.08), lack of physical activities (OR = 2.25; 95% CI: 1.11-4.57), presence of diabetes mellitus (OR = 1.79; 95% CI: 1.04-3.07), and having three or more children (OR = 2.39; 95% CI: 1.27-4.50). In contrast, factors associated with rural populations included female gender (OR = 2.03; 95% CI: 1.08-3.82), age (OR = 1.06; 95% CI: 1.03-1.08), exposure to pesticides (OR = 4.68; 95% CI: 1.27-17.21), history of encephalitis or meningitis (OR = 6.02; 95% CI: 1.92-18.85) and head trauma (OR = 1.89; 95% CI: 1.10-3.24).
Urban rural and populations showed different risk factors for CI, suggesting that different preventive strategies in these areas should be performed.
中国认知障碍(CI)患者数量持续上升。
调查城乡社区老年人中CI的患病率及危险因素。
我们对上海市马陆(农村社区,n = 4429)和五里桥(城市社区,n = 3471)社区7900名符合纳入标准的50岁及以上个体进行了CI面对面调查。采用简易精神状态检查表(MMSE)评估认知功能。在访谈过程中收集人口统计学特征和CI潜在危险因素的信息。进行多因素逻辑回归以确定与CI相关的危险因素。
根据教育程度校正后的MMSE评分,我们在农村社区确定了329例CI病例,在城市社区确定了227例。农村人口中CI患病率为7.43%,城市人口中为6.54%(p = 0.13)。在城市人口中,患CI的风险与年龄(OR = 1.04;95%CI:1.01 - 1.08)、缺乏体育活动(OR = 2.25;95%CI:1.11 - 4.57)、患有糖尿病(OR = 1.79;95%CI:1.04 - 3.07)以及育有三个或更多子女(OR = 2.39;95%CI:1.27 - 4.50)有关。相比之下,与农村人口相关的因素包括女性(OR = 2.03;95%CI:1.08 - 3.82)、年龄(OR = 1.06;95%CI:1.03 - 1.08)、接触农药(OR = 4.68;95%CI:1.27 - 17.21)、有脑炎或脑膜炎病史(OR = 6.02;95%CI:1.92 - 18.85)和头部外伤(OR = 1.89;95%CI:1.10 - 3.24)。
城乡人口CI的危险因素不同,提示应在这些地区实施不同的预防策略。