Centre for Brain Research, Indian Institute of Science, Bangalore, India.
Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK.
Alzheimers Dement. 2024 Apr;20(4):2943-2951. doi: 10.1002/alz.13771. Epub 2024 Mar 9.
Hypertension and diabetes are modifiable risk factors for dementia. We aimed to assess rural-urban disparities in the diagnosis and treatment of these conditions among aging Indians.
Participants (n = 6316) were from two parallel, prospective aging cohorts in rural and urban India. Using self-report and clinical/biochemical assessments, we subdivided participants with diabetes and hypertension into undiagnosed and untreated groups. Logistic regression and Fairlie decomposition analysis were the statistical methods utilized.
There was a significant rural-urban disparity in undiagnosed hypertension (25.14%), untreated hypertension (11.75%), undiagnosed diabetes (16.94%), and untreated diabetes (11.62%). Further, sociodemographic and lifestyle factors, such as age and tobacco use were the common contributors to the disparities in both undiagnosed hypertension and undiagnosed diabetes, whereas education and body mass index (BMI) were significant contributors to the disparity in untreated hypertension.
Rural Indians face significant healthcare disadvantages as compared to their urban counterparts, which prompts the urgent need for strategies for equitable healthcare.
高血压和糖尿病是导致痴呆的可改变风险因素。我们旨在评估印度农村和城市老年人中这些疾病的诊断和治疗的城乡差异。
参与者（n=6316）来自印度农村和城市的两个平行的前瞻性老龄化队列。使用自我报告和临床/生化评估，我们将患有糖尿病和高血压的参与者分为未确诊和未治疗的组。使用逻辑回归和费尔利分解分析进行统计分析。
未确诊高血压（25.14%）、未治疗高血压（11.75%）、未确诊糖尿病（16.94%）和未治疗糖尿病（11.62%）方面存在显著的城乡差异。此外，年龄和吸烟等社会人口和生活方式因素是未确诊高血压和未确诊糖尿病差异的共同原因，而教育和体重指数（BMI）是未治疗高血压差异的重要原因。
与城市同龄人相比，印度农村人面临着严重的医疗保健劣势，这促使我们迫切需要制定公平的医疗保健策略。
