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社会经济差异和痴呆性别不平等:来自中等收入国家的社区居住人群研究。

Socioeconomic Disparities and Gender Inequalities in Dementia: a Community-Dwelling Population Study from a Middle-Income Country.

机构信息

Department of Population Studies, El Colegio de la Frontera Norte, Carretera Escénica Km 18.5 San Antonio del Mar, 22560, Tijuana, Baja California, Mexico.

Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogota, Colombia.

出版信息

J Cross Cult Gerontol. 2021 Mar;36(1):105-118. doi: 10.1007/s10823-020-09418-4. Epub 2020 Nov 27.

Abstract

The proportion of the world's older adults and of its dementia cases is increasing in low and middle-income countries. This is particularly true in Colombia. There, the number of individuals with dementia may increase five-fold by 2050. Yet research is lacking on dementia in such settings. This work estimates the prevalence of dementia in a community-dwelling population in Colombia. It also assesses how gender-based differences in cardiovascular conditions and socioeconomic disparities affect dementia. This work analyzes data on 2000 respondents at least 60 years of age in the Health, Well-Being, And Aging (SABE) study in Bogota. Respondents with dementia are those who have cognitive impairment and at least two limitations in instrumental activities of daily living. The SABE study finds 8.4% of respondents have dementia. Age, cardiovascular risks, and socioeconomic disparities contributed to higher odds of dementia. The contributors to dementia can differ for men and women. For example, socioeconomic disparities were a larger contributor to dementia for women than men. The findings support the cognitive reserve hypothesis on dementia. This holds that pre-existing cognitive processes and compensatory mechanisms influence dementia. Women in Latin America are more likely to suffer from socioeconomic disparities that limit their cognitive reserve. This research points to several policy implications that can help offset these disparities and reduce the prevalence of dementia.

摘要

世界上老年人和痴呆症病例的比例在中低收入国家不断增加。哥伦比亚尤其如此。到 2050 年,该国痴呆症患者的数量可能会增加五倍。然而,在这种环境下,关于痴呆症的研究还很缺乏。这项工作估计了哥伦比亚一个社区居民中痴呆症的患病率。它还评估了心血管疾病性别差异和社会经济差距如何影响痴呆症。该研究分析了波哥大健康、福利和老龄化研究(SABE)中至少 60 岁的 2000 名受访者的数据。患有痴呆症的受访者是那些认知能力受损且日常生活活动中至少有两种活动受限的人。SABE 研究发现,8.4%的受访者患有痴呆症。年龄、心血管风险和社会经济差距导致痴呆症的几率更高。导致痴呆症的因素在男性和女性中可能不同。例如,社会经济差距对女性痴呆症的影响大于男性。这些发现支持了痴呆症的认知储备假说。该假说认为,先前存在的认知过程和补偿机制会影响痴呆症。拉丁美洲的女性更有可能遭受限制其认知储备的社会经济差距的影响。这项研究提出了一些政策含义,可以帮助弥补这些差距并降低痴呆症的患病率。

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