Population-attributable fractions of risk factors for all-cause dementia in China rural and urban areas: a cross-sectional study

• DOI: 10.1007/s00415-021-10886-y
• Publication Date: 2021-11-28T04:20:52Z
• Authors: Fei-fei Hu; Gui-rong Cheng; Dan Liu; Qian Liu; Xu-guang Gan; Lin Li; Xiao-dan Wang; Bo Zhang; Li-na An; Cong Chen; Ming-jun Zou; Lang Xu; Yang-ming Ou; Yu-shan Chen; Jin-quan Li; Zhen Wei; Yue-yi Wang; Qiong Wu; Xing-xing Chen; Xi-fei Yang; Qing-ming Wu; Lei Feng; Jing-jing Zhang; Heng Xu; Ya-fu Yu; Meng-liu Yang; Jin Qian; Peng-fei Lian; Li-yan Fu; Ting-ting Duan; Yuan Tian; Xi Cheng; Xin-wen Li; Pin-ting Yan; Guowei Huang; Hongxin Dong; Yong Ji; Yan Zeng
• Keywords: Cross-sectional study

The prevalence of dementia in China, particularly in rural areas, is consistently increasing; however, research on population-attributable fractions (PAFs) of risk factors for dementia is scarce.We conducted a cross-sectional survey, namely, the China Multicentre Dementia Survey (CMDS) in selected rural and urban areas from 2018 to 2020. We performed face-to-face interviews and neuropsychological and clinical assessments to reach a consensus on dementia diagnosis. Prevalence and weighted PAFs of eight modifiable risk factors (six classical: less childhood education, hearing impairment, depression, physical inactivity, diabetes, and social isolation, and two novels: olfactory decline and being unmarried) for all-cause dementia were estimated.Overall, CMDS included 17,589 respondents aged ≥ 65 years, 55.6% of whom were rural residents. The age- and sex-adjusted prevalence for all-cause dementia was 9.11% (95% CI 8.96-9.26), 5.19% (5.07-5.31), and 11.98% (11.8-12.15) in the whole, urban, and rural areas of China, respectively. Further, the overall weighted PAFs of the eight potentially modifiable risk factors were 53.72% (95% CI 52.73-54.71), 50.64% (49.4-51.89), and 56.54% (55.62-57.46) in the whole, urban, and rural areas of China, respectively. The eight risk factors' prevalence differed between rural and urban areas. Lower childhood education (PAF: 13.92%) and physical inactivity (16.99%) were primary risk factors in rural and urban areas, respectively.The substantial urban-rural disparities in the prevalence of dementia and its risk factors exist, suggesting the requirement of resident-specific dementia-prevention strategies.