Department of Social Work, Rutgers University, Newark, New Jersey, USA.
Agriculture, Landscape and Environment, Institute for Agroecology, and Gund Institute for the Environment, University of Vermont, Burlington, Vermont, USA.
Gerontologist. 2024 Dec 1;64(12). doi: 10.1093/geront/gnae142.
While recognizing the acknowledged difference in dementia prevalence between Indigenous and non-Indigenous populations, most previous studies were conducted in the Global North. This study aims to examine the relationship between Indigenous ethnic identity and dementia status with a special focus on urban-rural differences among older adults in Ecuador.
Data came from Ecuador's Survey of Health, Welfare, and Aging, derived from a probability sample of households in Ecuador. The final sample comprised 4,984 adults aged 60 or older. Dementia status was assessed through 3 indicators: low scores on a cognitive assessment, the number of difficulties in instrumental activities of daily living, and self-reported dementia diagnosis. Logistic regression and multivariate decomposition analyses were utilized.
Indigenous participants, even after adjusting for sociodemographic and health-related factors, exhibited a higher likelihood of having dementia compared to their non-Indigenous counterparts. Among Indigenous participants, those residing in rural areas had a higher likelihood of having dementia status, while there was no significant urban-rural difference observed among non-Indigenous participants. Rural residency and covariates explain 91.0% of the observed difference in dementia prevalence between Indigenous and non-Indigenous older adults.
Indigenous older adults who are living in rural areas are at particularly high risk of having dementia largely because they have presently recognized modifiable risk factors. These findings underscore the urgent need to prioritize provisions of appropriate and equitable service related to dementia for Indigenous people living in rural areas outside high-income countries.
尽管认识到土著和非土著人群中痴呆症患病率的明显差异，但大多数先前的研究都在全球北方进行。本研究旨在研究厄瓜多尔老年人中土著民族认同与痴呆症状况之间的关系，并特别关注城乡差异。
数据来自厄瓜多尔的健康、福利和老龄化调查，该调查源自厄瓜多尔家庭的概率样本。最终样本包括 4984 名 60 岁或以上的成年人。痴呆症状况通过 3 个指标进行评估：认知评估得分低、日常生活活动中工具性活动的困难程度以及自我报告的痴呆症诊断。使用逻辑回归和多变量分解分析。
即使在调整了社会人口统计学和与健康相关的因素后，土著参与者患痴呆症的可能性仍高于非土著参与者。在土著参与者中，居住在农村地区的人患痴呆症的可能性更高，而在非土著参与者中，城乡之间没有明显差异。农村居住和协变量解释了土著和非土著老年人群中观察到的痴呆症患病率差异的 91.0%。
居住在农村地区的土著老年人大都存在可识别的、可改变的风险因素，因此他们患有痴呆症的风险特别高。这些发现强调了迫切需要为居住在高收入国家以外农村地区的土著人民提供与痴呆症相关的适当和平等服务。
