Background: Screening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence. Methods: In this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected through computerized random sampling from all administrative districts in Taiwan and were assessed using an in-person interview. We calculated the prevalence of MCI and dementia, with their risk factors examined using multivariable logistic regression. Results: The prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68-8.69), 6.63% (95% CI, 6.62-6.63), and 4.46% (95% CI, 4.46-4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural:urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones. Conclusions: Significantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied by urbanization status. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.

Hodgkin's disease (HD) is uncommon in Taiwan. In reviewing the clinicopathologic features of 50 cases, the authors found that the diagnosis of HD was complicated with non-Hodgkin's lymphoma (NHL). Fourteen cases were reclassified as NHL containing Reed-Sternberg (RS) giant cells, mostly peripheral T-cell lymphoma (PTL), and 34 cases as classic HD, which included 8 cases of lymphocyte predominance, 10 of nodular sclerosis, 12 of mixed cellularity, and 4 of lymphocyte depletion. For cases of HD, there was a bimodal age-incidence distribution with peaks at the third and fifth decades; 61.8% manifested Stage B symptoms and 80.6% had Stage III/IV disease. The group of patients with NHL, compared with those with classic HD, was found to be older (mean age, 41.4 years versus 33.1 years; P < 0.05), to have more extranodal disease (35.7% versus 8.8%, P < 0.05), less complete remission rate (25% versus 67.9%, P < 0.05), and shorter median survival (29 months versus 90 months). Most of the NHL patients originally were diagnosed as having atypical or unclassified HD. Thus, the authors conclude that the previous observation of a predominance of mixed cellularity HD in Asian regions may be attributable to the inclusion of PTL, which may mimic HD in histology. Because there is a marked difference in clinical behavior and prognosis, it is important to distinguish between HD and NHL containing RS giant cells in an area with a high incidence of PTL. Cancer 1992; 691254-1258. In Western countries, there is great progress in the diagnosis and treatment of Hodgkin's disease (HD), with a cure rate of more than 70%.'r2 However, it has been recognized for years that a distinctly different epidemiologic pattern of HD exists in underdeveloped countries.3 Recently, a proportion of cases of non-Hodgkin's lymphoma (NHL), particularly peripheral T-cell lymphoma (PTL), were found to contain Reed-Sternberg (RS) or RS-like giant cells and were thought to have been misdiagnosed as HD.4-6 As the classification and diagnosis of lymphoma become more clear and reliable, we reviewed cases previously diagnosed as HD to clarify the clinical picture of HD in Taiwan and to compare the clinicopathologic behaviors of HD and NHL containing RS-like cells. Patients and Methods

This cohort study assesses the risk of hospitalization for motor vehicle crash injuries among Taiwanese adults with young-onset dementia compared with age-matched individuals without dementia.

Background Few studies have examined the association of comorbid depression with health‐care utilization among dementia patients. This study compared health‐care utilization between dementia patients with and without comorbid depression. Methods Using Taiwan's National Health Insurance Research Database, we identified 10,710 patients with newly diagnosed dementia between 2005 and 2014: 1785 had comorbid depression (group 1) and 8925 did not (group 2). Patients were tracked for 1 year to evaluate outpatient, emergency, and inpatient service utilization and length of hospital stay (LOS). Multivariable regression was applied to examine the association between comorbid depression and health‐care utilization and analyze factors associated with inpatient visits and LOS. Results Group 1 had significantly fewer outpatient visits (β = −0.115; p < 0.001), more inpatient visits (β = 0.157; p = 0.005), and a longer LOS (β = 0.191; p < 0.001) than did group 2. The groups did not differ significantly in emergency visits (β = 0.030; p = 0.537). In group 1, age, gender, and specific comorbidities were predictors of inpatient visits; those factors and salary‐based insurance premiums were predictors of LOS. Conclusion Group 1 utilized less outpatient care but more inpatient care, suggesting health‐care service for these patients may be needed to improvement.