title: Demographic and socio-economic influences on community-based care and caregivers of people with dementia in China.
abstract: BACKGROUND
  Dementia is a major public health challenge and China has the largest population with dementia in the world. However, dementia care and caregivers for Chinese are less investigated.
  
  
  OBJECTIVE
  To evaluate demographic and socio-economic influences on dementia care, management patterns and caregiver burden in a household community-dwelling-based survey, using participants' care receipts and Zarit scale.
  
  
  METHODS
  Rural and urban communities across six provinces of China comprising 4837 residents aged ≥60 years, in whom 398 had dementia and 1312 non-dementia diseases.
  
  
  RESULTS
  People with dementia were less likely to receive care if they were living in rural compared to urban areas (Odd ratio (OR) = 0.20; 95%CI: 0.10-0.41), having education level below compared to above secondary school (OR = 0.24; 95%CI: 0.08-0.70), manual labourer compared to non-manual workers (OR = 0.27; 95%CI: 0.13-0.55), having personal annual income below RMB 10,000 yuan (£1000) compared to above (OR = 0.37; 95%CI: 0.13-0.74) or having four or more than compared to less four children (OR = 0.52; 95%CI: 0.27-1.00). Caregivers for dementia compared with those for non-dementia diseases were younger and more likely to be patients' children or children in-law, had lower education and spent more caring time. Caregiver burden increased with low education, cutback on work and caring for patients who were younger or living in rural areas, and this caregiver burden was three-fold greater than that for non-dementia diseases.
  
  
  CONCLUSIONS
  There are a number of inequalities in dementia care and caregiver burden in China. Reducing the socio-economic gap and increasing education may improve community care for people with dementia and preserve caregivers' well-being.
authors.affiliation: University of Wolverhampton, UK; Guangdong Medical University, China; Anhui Medical University, China.
authors.forename: Ruoling
authors.initials: R
authors.lastname: Chen
authors.affiliation: University of Wolverhampton, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Lang
authors.affiliation: University of Wolverhampton, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Clifford
authors.affiliation: Imperial College NHS Healthcare Trust, St. Mary's Hospital, UK.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Anhui Medical University, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Hu
authors.affiliation: University of London (ICR2UL) and Ashford and St Peter's NHS Foundation Trust, UK.
authors.forename: Thang S
authors.initials: TS
authors.lastname: Han
keywords: Care burden; epidemiology; socio-economic inequality