Affiliations: [a] Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden | [b] Center for Alzheimer Research at Karolinska Institutet, Stockholm, Sweden | [c] Centre for Research & Development, Uppsala University/County Council of Gävleborg, Sjukhuset i Gävle, Sweden | [d] University of Gävle, Gävle, Sweden | [e] Department of Geriatrics, Karolinska University Hospital, Stockholm, Sweden | [f] Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm Sweden | [g] The Swedish Dementia Centre, Stockholm, Sweden | [h] The Swedish Red Cross University College, Stockholm, Sweden
Correspondence:
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Correspondence to: Anders Wimo, MD, PhD, Adjunct Professor, Division of Neurogeriatrics, Department of Neurobiology, Care sciences and Society, Novum 5th floor, Karolinska Institutet, SE-14157 Huddinge, Sweden. Tel.: +46 70 5795383; Fax: +46 650 36614; E-mail: [email protected].
Abstract: Background:Recent studies suggest that trends in cardiovascular risk may result in a decrease in age-specific prevalence of dementia. Studies in rural areas are rare. Objectives:To study cohort effects in dementia prevalence and survival of people with dementia in a Swedish rural area. Methods:Participants were from the 1995-1998 Nordanstig Project (NP) (n = 303) and the 2001-2003 Swedish National study on Aging and Care in Nordanstig (SNAC-N) (n = 384). Overall 6-year dementia prevalence and mortality in NP and SNAC-N were compared for people 78 years and older. Logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for dementia occurrence using the NP study population as the reference group. Cox regression models were used to analyze time to death. Results:The crude prevalence of dementia was 21.8% in NP and 17.4% in SNAC-N. When the NP cohort was used as the reference group, the age- and gender-adjusted OR of dementia was 0.71 (95% CI 0.48–1.04) in SNAC-N; the OR was 0.47 (0.24–0.90) for men and 0.88 (0.54–1.44) for women. In the extended model, the OR of dementia was significantly lower in SNAC-N than in the NP cohort as a whole (0.63; 0.39–0.99) and in men (0.34; 0.15–0.79), but not in women (0.81; 0.46–1.44). The Cox regression models indicated that the hazard ratio of dying was lower in the SNAC-N than NP population. Conclusions:Trends toward a lower prevalence of dementia in high-income countries seem to be evident in this Swedish rural area, at least in men.
Keywords: Dementia, mortality, prevalence, rural population
