• Chih-Ching Liu, Chien-Hui Liu, Yu Sun, Huey-Jane Lee, Li-Yu Tang, and Ming-Jang Chiu.
• Department of Healthcare Administration, College of Medical and Health Science, Asia University.
• J Epidemiol. 2021 Apr 10.

BackgroundScreening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence.MethodsIn this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected by computerized random sampling from all administrative districts in Taiwan and were assessed by an in-person interview. We calculated the prevalence of MCI and dementia with their risk factors examined by multivariable logistic regression.ResultsThe prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68-8.69), 6.63% (95% CI, 6.62-6.63), and 4.46% (95% CI, 4.46-4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural/urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones.ConclusionsSignificantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied between urbanization statuses. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.

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