Socio-demographic variation of dementia subtypes in china: Methodology and results of a prevalence study in Beijing, Chengdu, Shanghai, and Xian.
OBJECTIVE
To characterize sociodemographic variations in the prevalence of AD and VaD in China.


METHODS
Data were collected in a 1997-1998, cross-sectional, door-to-door prevalence survey of 34,807 community residents ages > or =55 years in Beijing, Shanghai, Chengdu and Xian. Initial diagnoses of AD and VaD were assessed by clinicians using standardized protocols, according to the NINCDS-ADRDA and NINDS-AIREN criteria; diagnoses were confirmed after 6 months by repeating neuropsychological evaluations. Prevalence odds ratios were estimated in logistic models adjusting for survey design, age, and other sociodemographic factors.


RESULTS
We identified 732 prevalent cases of AD and 295 cases of VaD. Adjusting for all sociodemographic factors concurrently, prevalence odds of AD and VaD were higher in northern versus southern China. Age trends for AD appeared different in western and eastern China. AD also showed an age-adjusted elevation among women and, in the fully adjusted model, a gender education interaction indicating a female preponderance in the highest education group. North-south variation for VaD was age-dependent. In the fully adjusted model, for AD, widowed had significantly higher prevalence odds; for VaD, widowed persons and minorities had significantly lower prevalence odds; professionals had statistically significant and borderline lower prevalence odds for both VaD and AD; sales-service occupations had significantly lower odds for AD only.


CONCLUSIONS
We observed variations in prevalence for AD and VaD in different regions and demographic groups in China that persisted after controlling for potential confounding factors. Sociodemographic factors are probable surrogates for conditions such as lifestyle, environment, comorbidities, and life expectancy.
Zhang
Zhen-Xin
ZX
Department of Clinical Epidemiology, Peking Union Medical College Hospital, Beijing, PR China. zhangzx@pumch.cn
Zahner
Gwendolyn E P
GE
Román
Gustavo C
GC
Liu
Xie-He
XH
Wu
Cheng-Bing
CB
Hong
Zhen
Z
Hong
Xia
X
Tang
Mao-Ni
MN
Zhou
Bing
B
Qu
Qiu-Ming
QM
Zhang
Xiao-Jun
XJ
Li
Hui
H
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003704:Dementia / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D015140:Dementia, Vascular / Q000453:epidemiology; D004493:Education; D004812:Epidemiologic Methods; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009790:Occupations; D018579:Patient Selection; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population