Objectives-To estimate the prevalence of dementia in an elderly rural population and to determine the effects of age, sex, and education. Methods-To obtain prevalence estimates of both cognitive impairment and dementia a door to door two phase population survey was carried out in three rural villages in central Italy. Of 1147 inhabitants older than 64, 968 (84-4%) completed the protocol. Results-The prevalence rates (cases per 100 population over 64) were 8-0 for dementia and 27-3 for cognitive impairment. The prevalence rate for dementia did not differ between men and women (7.9 v 8-2), but increased with age (from 1*1 at age 65-69 to 34-8 at age 90-96). Subjects with less than three years of schooling had a significantly higher prevalence of dementia (14-6; 95% confidence interval (95% CI) 10.2-19.1) than subjects with three or more years of schooling (5.9; 95% CI 4.2-7.7). At the multivariate logistic analysis, the risk related with a low level of education was still present after adjustment for age and sex (OR = 2-0; 95% CI 1.2-3.3).Alzheimer's disease was diagnosed in 64% of the 78 demented patients, vascular dementia in 27%, and other dementing diseases in 9%. Conclusions-In both Alzheimer and vascular dementia subtypes, the prevalence rates did not differ between men and women, but increased with age and were higher in subjects with a low level of education. (7 Neurol Neurosurg Psychiatry 1996;60:628-633) Keywords: dementia; education; rural populationThe progressive aging of the population is associated with a steady increase in all age related diseases. Among these, dementing disorders cause great concern because of their peculiar disabling effects. Despite the interest in this condition, prevalence estimates show pronounced variations due to differences in case ascertainment procedures, diagnostic criteria, age distribution, and the rural or urban location of the populations studied.'8 Furthermore, education and occupation may influence the cognitive performance and increase the risk of dementia.9-'3The present study analyses baseline data obtained in a door to door prospective population survey on cognitive impairment and functional disability of people older than 64 (AQUILA study). Here we report the effects of age, gender, and education on the prevalence of dementia. MethodsWe selected three rural villages (Poggio Picenze, Scoppito, Tornimparte) near the town of L'Aquila (central Italy) because of their population size (a total of 1147 people over 64), population stability (only 0-2% of people over 59 had moved elsewhere in the five years preceding the prevalence day), and the active collaboration offered by family doctors.The study was conducted on all persons over 64 residing in the selected villages on the prevalence day (1 March 1992). The ascertainment of cases was made between March 1992 and February 1993 by means of a door to door two phase design. Four lay interviewers (MLB, MC, CG, and GM) and four doctors (ARC, CF, MTL, and PC) conducted the first (screening interview) and the s...
Prevalence, awareness, treatment and control of hypertension were assessed in 1032 (90%) of 1147 elderly (у65 years) inhabitants of three Italian villages. Blood pressure (BP) was measured at home on two separate occasions following a standardised protocol. Persons taking antihypertensive drugs or with BP values у140/90 mm Hg were considered as affected by hypertension. Prevalence of hypertension was 64.8%, with higher rates in women than men, and in those aged 75-84 than in those aged 65-74. Diabetes, strokes and hypercholesterolaemia were more frequent in hypertensive than normotensive people, whereas cardiac diseases, overweight and smoking did not differ significantly between hypertensive and normotensive people. Of the 669 hypertensive patients, 439 (65.6%) were aware of their hypertension, 398 (59.5%) were being treated, and 70 (10.5%) had their hypertension con-
In our population, the prevalence of stroke was higher than in previous studies. Stroke survivors were more disabled and more at risk for dementia than stroke-free subjects.
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