St John Philip D, Seary Judith, Menec Verena H, Tyas Suzanne L
Centre on Aging; Section of Geriatric Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Can J Rural Med. 2016 Summer;21(3):73-9.
We sought to determine whether residence in a rural region is associated with a higher risk of dementia and a higher risk of developing dementia over a 5-year period than residence in an urban region.
This was a secondary analysis of a prospective cohort study. In 1991 and 1992, 1751 adults aged 65 years and older and residing in the community were sampled from a representative population-based registry, which included the entire province (time 1). Follow-up occurred 5 years later (time 2). Age, sex and education were selfreported. Rurality was determined by the population of the Census subdivision, with a population greater than 19 999 considered urban. Cognition was assessed using the Modified Mini-Mental State Examination, with those scoring below 78 invited to undergo a clinical examination to determine the presence of dementia. Cross-sectional analyses were conducted for participants with complete data at time 1. Prospective analyses were conducted for participants with normal cognition at time 1, who had complete data and survived until time 2. Logistic regression models were constructed for the outcome of dementia at times 1 and 2.
Residence in a rural region was not associated with dementia in the cross-sectional analyses (adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 0.61-1.91) and did not predict dementia 5 years later (adjusted OR 1.05, 95% CI 0.66-1.68).
We found no difference in the risk of dementia among older adults living in urban and rural regions of Manitoba.
我们试图确定,与居住在城市地区相比,居住在农村地区是否与患痴呆症的风险更高以及在5年期间患痴呆症的风险增加有关。
这是一项前瞻性队列研究的二次分析。1991年和1992年,从一个具有代表性的基于人群的登记处(涵盖全省)中抽取了1751名65岁及以上居住在社区的成年人(时间1)。5年后进行随访(时间2)。年龄、性别和教育程度通过自我报告获取。农村地区由人口普查分区的人口确定,人口超过19999的地区被视为城市地区。使用改良的简易精神状态检查表评估认知情况,得分低于78分的人被邀请接受临床检查以确定是否患有痴呆症。对在时间1有完整数据的参与者进行横断面分析。对在时间1认知正常、有完整数据且存活至时间2的参与者进行前瞻性分析。构建时间1和时间2时痴呆症结局的逻辑回归模型。
横断面分析中,居住在农村地区与痴呆症无关(调整后的优势比[OR]为1.08,95%置信区间[CI]为0.61 - 1.91),并且不能预测5年后的痴呆症(调整后的OR为1.05,95% CI为0.66 - 1.68)。
我们发现,曼尼托巴省城乡地区的老年人患痴呆症的风险没有差异。