Zhongguo quanke yixue (Oct 2023)
Epidemiological Characteristics of Dementia and Its Correlation with Multimorbidity among Residents Aged 65 and Above
Abstract
Background In the context of aging society in China, the prevalence of Alzheimer's disease increases and multimorbidity becomes more common with years. However, the extensive investigations of Alzheimer's disease in Hunan province have not been reported adequately and the multimorbidity relationship between relevant diseases remains unclear. Objective To completely understand the prevalence of Alzheimer's disease in residents aged 65 or above in Hunan and analyze its multimorbidity relationships with 11 common chronic diseases. Methods The residents aged 65 years and above in 30 districts (counties), 60 streets (townships), and 180 neighborhood (village) committees in Hunan Province were randomly selected between April and May 2021 by using stratified multistage sampling method. Alzheimer's disease was diagnosed by a neurologist or psychiatrist using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), after using the Community Screening Interview for Dementia (CSI-D) or the 8-item ascertain dementia (AD8) as the screening tools. In addition, all respondents were investigated for the prevalence of hypertension, cerebrovascular disease, ischemic heart disease, rheumatoid arthritis, intervertebral disc disease, diabetes, gastroenteritis, chronic obstructive pulmonary disease, calculous cholecystitis, peptic ulcer and cancer. Results A total of 5 979 residents were sampled, 5 616 of them completed the examinations and 785 (13.98%) were diagnosed with Alzheimer's disease. There were significant differences in the prevalence of Alzheimer's disease among respondents with different regions, gender, age, smoking history and presence of other chronic diseases (P<0.05). The total number of patients with other chronic diseases among all respondents was 5 606, with the top five diseases of hypertension〔2 205 (39.33%) 〕, intervertebral disc disease〔553 (9.86%) 〕, diabetes 〔526 (9.38%) 〕, cerebrovascular disease〔492 (8.78%) 〕, and ischemic heart disease〔467 (8.33%) 〕. The top five diseases in the dementia patients were hypertension〔325 (41.40%) 〕, cerebrovascular disease〔111 (14.14%) 〕, ischemic heart disease〔91 (11.59%) 〕, rheumatoid arthritis 〔89 (11.33%) 〕, and intervertebral disc disease〔81 (10.31%) 〕. The prevalence of dementia in patients with no chronic disease, with 1, 2, 3 or more types of other chronic diseases was 11.46% (214/1 867), 13.66% (309/2 262), 17.50% (176/1 006), and 18.26% (86/471), respectively. There were statistically significant differences in the prevalence of Alzheimer's disease between the subjects with and without gastroenteritis, rheumatoid arthritis, cerebrovascular disease, chronic obstructive pulmonary disease, and ischemic heart disease, respectively (P<0.05). Binary Logistic regression analysis showed that living in rural areas〔OR=2.048, 95%CI (1.655, 2.536) 〕, female〔OR=1.388, 95%CI (1.163, 1.655) 〕, aging〔OR=1.348, 95%CI (1.270, 1.431) 〕, and suffering from other chronic diseases〔OR=1.195, 95%CI (1.101, 1.297) 〕 were risk factors for the development of Alzheimer's disease in residents aged 65 years and above (P<0.05). The investigation results of timely medication taking in the patients with Alzheimer's disease showed that 12.79% (99/774) reported difficulties, 6.59% (51/774) needed help, and 2.97% (23/774) were unable to complete independently. Conclusion The prevalence of Alzheimer's disease in residents aged 65 years and above in Hunan Province increases with the number of other chronic diseases and correlates with multiple diseases. Great attention should be paid on the self-care ability and family care burden of Alzheimer's disease by society. The prevalence and multimorbidity of Alzheimer's disease were basically grasped by the investigation, in order to provide an objective basis for the formulation of policies on its prevention and treatment.
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