Urban–rural disparities in mild cognitive impairment and its functional subtypes among community-dwelling older residents in central China

Abstract

BackgroundSubstantial variations in the prevalence of mild cognitive impairment (MCI) and its subtypes have been reported, although mostly in geographically defined developed countries and regions. Less is known about MCI and its subtypes in rural areas of less developed central China.AimsThe study aimed to compare the prevalence of MCI and its subtypes in residents aged 65 years or older in urban and rural areas of Hubei Province, China.MethodsParticipants aged 65 years or older were recruited between 2018 and 2019. Inperson structured interviews and clinical and neuropsychological assessments were performed at city health community centres and township hospitals.ResultsAmong 2644 participants without dementia, 735 had MCI, resulting in a prevalence of 27.8% for total MCI, 20.9% for amnestic MCI (aMCI) and 6.9% for non-amnestic MCI (naMCI). The prevalence of MCI in urban and rural areas was 20.2% and 44.1%, respectively. After adjusting for demographic factors, the prevalence of total MCI, aMCI and naMCI differed significantly between rural and urban areas (adjusted odds ratio (OR) 2.10, 1.44 and 3.76, respectively). Subgroup analysis revealed an association between rural socioeconomic and lifestyle disadvantage and MCI and its subtypes.ConclusionsOur findings suggest that the prevalence of MCI among urban residents in central China is consistent with that in other metropolis areas, such as Shanghai, but the prevalence in rural areas is twice that in urban areas. Prospective studies and dementia prevention in China should focus on rural areas.

Correlation between serum lipid profiles and cognitive impairment in old age: a cross-sectional study

“…In urban areas, older adults have a relatively high level of education, healthy lifestyles (less smoking and drinking and more physical activities) and better health conditions (lower ratio of hypertension and diabetes). 37 However, significant urban-rural differences remained between the serum lipid parameters and cognitive impairment in the adjusted model 2. This suggests that rural-dwelling older adults should be considered a priority for the prevention of cognitive impairment.…”

“…One possible reason for these differences in lipids and cognitive impairment is that in rural areas, older adults have a lower education level and there is a higher rate of hypertension. In urban areas, older adults have a relatively high level of education, healthy lifestyles (less smoking and drinking and more physical activities) and better health conditions (lower ratio of hypertension and diabetes) 37. However, significant urban-rural differences remained between the serum lipid parameters and cognitive impairment in the adjusted model 2.…”

Alzheimer's disease diagnosis and management: Perspectives from around the world

“…44 In addition to vascular complication, a study comparing the prevalence of MCI in people aged 65 or older in urban and rural areas of China, reported that the prevalence of MCI in rural areas of China is twice that of urban areas, suggesting a pressing need to improve AD management in rural China. 45 The overlap of stroke and early AD in China complicates clinical diagnosis, especially given the large population. For example, a 75year-old retired engineer first presented in 2014 with memory loss, reporting that he had forgotten the names of people he had known for years.…”

“…Hypoperfusion may also exacerbate tau pathology through the upregulation of tau‐phosphorylating enzymes and indirectly via the amyloid cascade 44 . In addition to vascular complication, a study comparing the prevalence of MCI in people aged 65 or older in urban and rural areas of China, reported that the prevalence of MCI in rural areas of China is twice that of urban areas, suggesting a pressing need to improve AD management in rural China 45 …”

Efficacy of comprehensive cognitive health management for Shanghai community older adults with mild cognitive impairment

“…Mild cognitive impairment (MCI) is a transitional state between normal ageing and early dementia. The prevalence of MCI in older adults aged 60 years or above in China ranges from 15.5% to 27.8%, and the proportion of MCI progressing to AD within 5 years is 10%–15% every year 5 6…”