Gender Differences in Cognitive Impairment among Rural Elderly in China

Int J Environ Res Public Health. 2020 May 25;17(10):3724. doi: 10.3390/ijerph17103724.


Elders in rural areas of developing countries are particularly vulnerable to cognitive impairment and gender disparities are notable. Yet, evidence related to gender differences in cognitive impairment in these settings is scarce. This study examined gender differences in cognitive impairment among elderly people aged 65 and above in rural China. A multi-site cross-sectional survey was conducted. In total, 550 males and 700 females were recruited. The Chinese version of the Mini-Mental Status Examination was applied for cognitive impairment screening. Demographic information, lifestyle factors, psychosocial factors, and health-related information were assessed. The prevalence of cognitive impairment was 40.0%in males and 45.1% in females, respectively. Females showed significant higher prevalence after age 75 (62.7% vs. 45.4%, p < 0.005). Older age, hearing impairment, and activities of daily living dependence were common factors associated with cognitive impairment in both females and males. For males, living in a neighborhood with poor social interactions and diabetes were risk factors, while tea consumption was a protective factor. For females, vision impairment and illiteracy were additional risk factors. Individualized interventions and standardized measurements of cognitive function should be developed to suit older populations living in rural and less-developed areas, through collective efforts involving all stakeholders and multidisciplinary teamwork.

Keywords: China; cognitive impairment; epidemiology; gender difference; risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • China
  • Cognitive Dysfunction*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Prevalence
  • Risk Factors
  • Rural Population*
  • Sex Factors