Department of Health Sciences, Brock University, St. Catharines, ON, Canada.
Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada.
J Alzheimers Dis. 2018;64(1):303-308. doi: 10.3233/JAD-171150.
BACKGROUND/OBJECTIVE: To compare Alzheimer's disease (AD) mortality rates and coinciding risk factors in rural and urban Texas populations.
155 Texas counties were divided into 73 rural and 82 urban areas using the U.S. Census Bureau definition of rurality. Changes in age-adjusted AD mortality across these counties were calculated using a 7-year aggregation model from 2000-2006 and 2009-2015. Data pertaining to gender, race, education, obesity, diabetes, physical inactivity, and lithium concentrations in tap water were also collected from readily available databases.
Change in age-adjusted AD mortality was higher in rural counties (9.5±1.4) versus urban (5.9±1.1) over the time period examined. Similarly, obesity (30.2±0.2% ), diabetes (11.0±0.1% ), and physical inactivity (29.4±0.2% ) levels were significantly higher in rural populations compared to urban (29.1±0.2%, 9.7±0.1%, and 26.7±0.3, respectively). In contrast, the percent of population with some college education (40.1±0.7% ) was lower compared to urban (29.4±0.2% and 44.4±0.9%, respectively). Lithium concentrations in tap water was significantly lower in rural counties compared to urban (63.3±8.2 and 33.4±4.7μg/L, respectively). No significant differences were observed among females and however, we did find significant differences in the percent of African American and Hispanics. Correlational analysis uncovered a negative association between education status and AD mortality over time (r = -0.17). Further analysis controlling for physical inactivity, education, and trace lithium concentrations results in a loss of statistical significance.
AD mortality rates are higher in rural counties when compared to urban counties, and this may be linked to greater physical inactivity, obesity, and diabetes, as well as lower trace lithium levels in tap water.
背景/目的：比较德克萨斯州农村和城市人群中阿尔茨海默病（AD）的死亡率和相关风险因素。
根据美国人口普查局的农村定义，将德克萨斯州的 155 个县分为 73 个农村地区和 82 个城市地区。使用 2000-2006 年和 2009-2015 年的 7 年聚合模型计算这些县的年龄调整后 AD 死亡率变化。还从现成的数据库中收集了与性别、种族、教育程度、肥胖、糖尿病、身体活动不足和自来水中锂浓度相关的数据。
在所研究的时间段内，农村县的年龄调整后 AD 死亡率变化（9.5±1.4）高于城市县（5.9±1.1）。同样，农村人口的肥胖率（30.2±0.2%）、糖尿病（11.0±0.1%）和身体活动不足（29.4±0.2%）水平明显高于城市人口（29.1±0.2%、9.7±0.1%和 26.7±0.3%）。相比之下，具有一定大学教育程度的人口比例（40.1±0.7%）低于城市人口（分别为 29.4±0.2%和 44.4±0.9%）。自来水中的锂浓度在农村县明显低于城市县（分别为 63.3±8.2μg/L 和 33.4±4.7μg/L）。女性之间没有观察到显著差异，但我们确实发现了非裔美国人和西班牙裔之间的显著差异。相关性分析发现，随着时间的推移，教育程度与 AD 死亡率之间存在负相关关系（r=-0.17）。进一步分析控制身体活动不足、教育程度和痕量锂浓度后，统计学意义丧失。
与城市县相比，农村县的 AD 死亡率更高，这可能与身体活动不足、肥胖、糖尿病以及自来水中痕量锂水平较低有关。
