School of Public Health, Zhejiang University, Hangzhou, China.
School of Public Affairs, Zhejiang University, Hangzhou, China.
Front Public Health. 2023 Mar 24;11:1100960. doi: 10.3389/fpubh.2023.1100960. eCollection 2023.
Evidence of spatial disparity in dementia mortality in China has been found to have higher dementia mortality in eastern and rural China. Regional factors of physical and social features may be influencing this spatial disparity. However, the extent of spatial difference in dementia mortality across small regional localities is unclear. This study aims to investigate the geographic variations in mortality and risk of all dementia subtypes and identify the effect of the associated environmental risk factors.
We used surveillance data on death reports from Alzheimer's disease and other forms of dementia in Zhejiang province from 2015 to 2019. We estimated the relative risk of dementia mortality using a Bayesian spatial model. We mapped predicted relative risk to visualize the risk of death from different types of dementia and to identify risk factors associated with dementia.
Thirty thousand three hundred and ninety-eight deaths attributable to dementia as the underlying or related cause (multiple causes) were reported during 2015-2019. Counties and districts in the southeast and west of Zhejiang province had significantly higher standardized mortality ratios than others. Counties and districts with a smaller proportion of residents aged 60 years or older, poorer economic status, insufficient health resources, and worse pollution had a higher risk of deaths due to dementia.
Higher risks of dementia mortality were found in counties and districts with poorer economic status, insufficient health resources, and worse pollution in Zhejiang. Our study adds new evidence on the association between socioeconomic and environmental factors and the mortality risk due to dementia.
在中国，痴呆症死亡率存在空间差异，东部和农村地区的痴呆症死亡率较高。身体和社会特征的区域因素可能会影响这种空间差异。然而，痴呆症死亡率在小区域之间的空间差异程度尚不清楚。本研究旨在调查全因痴呆症死亡率的地理变化，并确定相关环境风险因素的影响。
我们使用了 2015 年至 2019 年浙江省阿尔茨海默病和其他形式痴呆症死亡报告的监测数据。我们使用贝叶斯空间模型估计了痴呆症死亡率的相对风险。我们绘制了预测的相对风险图，以可视化不同类型痴呆症的死亡风险，并确定与痴呆症相关的风险因素。
2015-2019 年报告了 3398 例归因于痴呆症的死亡（多种原因）。浙江省东南部和西部的县和区标准化死亡率比其他地区显著更高。居民中 60 岁及以上人口比例较小、经济状况较差、卫生资源不足和污染较严重的县和区，痴呆症死亡风险更高。
在经济状况较差、卫生资源不足和污染较严重的县和区，痴呆症死亡率较高。本研究为社会经济和环境因素与痴呆症死亡率之间的关系提供了新的证据。
