Clarke Antonia J, Ahmed Marwan, Katzenellenbogen Judith M, Towney Wiradjuri John, Balabanski Anna H, Withall Dharawal Yuin Adrienne, Radford Kylie, Brodtmann Amy
Monash University, Melbourne, VIC.
University of Sydney, Sydney, NSW.
Med J Aust. 2025 May 2. doi: 10.5694/mja2.52657.
To determine the nationwide prevalence of dementia as it intersects with rurality for Aboriginal and Torres Strait Islander and non-Indigenous peoples in Australia.
Cross-sectional population-based prevalence study using nationwide respondent-reported data.
SETTING, PARTICIPANTS: All people aged 45 years and older, including people living in residential aged care facilities, hospitals and prisons, who responded to the 2021 Australian census.
Crude, age-specific and age-standardised dementia prevalence, and odds of dementia, for Aboriginal and Torres Strait Islander and non-Indigenous peoples across remoteness levels.
For non-Indigenous peoples, the crude and age-standardised (World Health Organization standard) prevalence of dementia was 10.6 and 7.4 per 1000 persons, respectively. For Aboriginal and Torres Strait Islander peoples, the crude and age-standardised prevalence was 13.4 and 16.2 per 1000 persons, respectively. The age-specific prevalence ratio for Aboriginal and Torres Strait Islander and non-Indigenous peoples was most pronounced at younger age bands (3.5 for 45-49 years, 3.8 for 50-54 years and 3.4 for 60-64 years), narrowing to 1.6 among those aged 80-84 years. Odds of dementia decreased significantly with increasing remoteness for non-Indigenous peoples, but not for the Aboriginal and Torres Strait Islander population. Increasing age and no educational attainment were strongly associated with increased odds of dementia across both populations.
Consideration of geography is of crucial significance in dementia epidemiology, particularly for Aboriginal and Torres Strait Islander peoples. Our findings confirm those of previous community cohort and linked data studies that highlight the disproportionate burden of dementia borne by Aboriginal and Torres Strait Islander peoples using a national dataset. Place should inform targeted health care policy to address risk and protective factors for dementia prevention and care.
确定在澳大利亚，痴呆症在原住民和托雷斯海峡岛民以及非原住民中与农村地区交叉的全国患病率。
基于全国范围内受访者报告数据的横断面人群患病率研究。
地点、参与者：所有45岁及以上的人群，包括居住在老年护理机构、医院和监狱中的人群，他们对2021年澳大利亚人口普查做出了回应。
原住民和托雷斯海峡岛民以及非原住民在不同偏远程度下的痴呆症粗患病率、年龄别患病率和年龄标准化患病率，以及痴呆症的患病几率。
对于非原住民，痴呆症的粗患病率和年龄标准化（世界卫生组织标准）患病率分别为每1000人10.6例和7.4例。对于原住民和托雷斯海峡岛民，粗患病率和年龄标准化患病率分别为每1000人13.4例和16.2例。原住民和托雷斯海峡岛民与非原住民的年龄别患病率比在较年轻年龄组最为明显（45 - 49岁为3.5，50 - 54岁为3.8，60 - 64岁为3.4），在80 - 84岁人群中缩小至1.6。对于非原住民，痴呆症的患病几率随着偏远程度增加而显著降低，但对于原住民和托雷斯海峡岛民群体则不然。在这两个人群中，年龄增长和未接受教育都与痴呆症患病几率增加密切相关。
在痴呆症流行病学中，考虑地理位置至关重要，尤其是对于原住民和托雷斯海峡岛民。我们的研究结果证实了先前社区队列研究和关联数据研究的结果，这些研究使用全国数据集强调了原住民和托雷斯海峡岛民所承受的痴呆症负担不成比例。地点应告知有针对性的医疗保健政策，以解决痴呆症预防和护理的风险及保护因素。
