Prevalence and Risk Factor of Cognitive Impairment were Different between Urban and Rural Population: A Community-Based Study

J Alzheimers Dis. 2016;49(4):917-25. doi: 10.3233/JAD-150748.


Background: China is facing a continuously rising numbers of people with cognitive impairment (CI).

Objectives: To investigate the prevalence and risk factors of CI among elderly people living in rural and urban communities.

Methods: We conducted a face-to-face survey of CI on 7,900 individuals aged 50 years or older meeting inclusion criteria in the Malu (rural community, n = 4,429) and Wuliqiao (urban community, n = 3,471) communities of Shanghai. The Mini-Mental State Examination (MMSE) was used to evaluate the cognitive function. Information on demographic features and potential risk factors for CI was collected during the interview. Multivariate logistic regression was performed to identify risk factors associated with CI.

Results: Based on the education modified MMSE score, we identified 329 CI cases in rural community and 227 in urban community. The prevalence of CI was 7.43% in rural population and 6.54% in urban population (p = 0.13). In the urban population, risk of having CI was associated with age (OR = 1.04; 95% CI: 1.01-1.08), lack of physical activities (OR = 2.25; 95% CI: 1.11-4.57), presence of diabetes mellitus (OR = 1.79; 95% CI: 1.04-3.07), and having three or more children (OR = 2.39; 95% CI: 1.27-4.50). In contrast, factors associated with rural populations included female gender (OR = 2.03; 95% CI: 1.08-3.82), age (OR = 1.06; 95% CI: 1.03-1.08), exposure to pesticides (OR = 4.68; 95% CI: 1.27-17.21), history of encephalitis or meningitis (OR = 6.02; 95% CI: 1.92-18.85) and head trauma (OR = 1.89; 95% CI: 1.10-3.24).

Conclusions: Urban rural and populations showed different risk factors for CI, suggesting that different preventive strategies in these areas should be performed.

Keywords: Cognitive impairment; prevalence; risk factors; rural population; urban population.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Cognition Disorders / epidemiology*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Risk Factors
  • Rural Population
  • Urban Population