| Background: Dementia is a slowly progressive disease characterized by changes in neurocognitive functions such as memory and thinking.Its main subtypes include Alzheimer’s disease and vascular dementia.Many studies have shown that the incidence rate of dementia is affected by long-term diseases such as hypertension,diabetes and depression.Co diseases(at least two)can exacerbate neuronal damage,but the impact of co diseases on dementia has not been fully elucidated.Objective: To explore the relationship between multimorbidity status and the risk of dementia among older people aged 65 and over in the community,and to find cost-effective prevention and control measures for cognitive impairment in the community.Methods: The study participants were from the baseline survey(2018-2020)of the Hubei Memory and Aging Cohort Study(registration number: Chi CTR1800019164).According to the unified inclusion and exclusion criteria,a total of 8221 elderly people ≥ 65 years old were included,who had completed a complete set of neuropsychological assessments and clinical physical examinations;The clinical diagnosis of dementia was completed by neurologists based on the 2018 Chinese Guidelines for the Diagnosis and Treatment of Dementia and Cognitive Disorders;Chronic diseases included in this article included hypertension,diabetes,coronary heart disease and cerebrovascular diseases.The comorbidity status was divided into no comorbidity group and comorbidity group according to whether had two or more chronic diseases.Chi-square test was used to compare the differences in the prevalence of dementia and the general characteristics among groups of older people living in different areas,age groups,and chronic disease conditions;Multivariate logistic regression was used to analyze the relationship between different chronic disease groups and their comorbidities and dementia.Results:(1)Among the 8221 participants,6282(76.3%)had chronic diseases,and2402(29.3%)had comorbidities;The number of patients with hypertension,diabetes,coronary heart disease and cerebrovascular disease was 5440(66.2%),1367(16.6%),1188(14.5%)and 1440(17.5%)respectively;3880(47.2%)had one chronic disease,1749(21.3%)had two chronic diseases,555(6.8%)had three chronic diseases and98(1.2%)had four chronic diseases.(2)The standardized prevalence rates of dementia among the total,urban,and rural older persons were 7.06%(95% CI:6.40-7.72),4.34%(95% CI: 3.81-4.87),and 11.53%(95% CI: 10.70-12.35),respectively.(3)After controlling for the effects of sociodemographic characteristics,lifestyle,and physiological indicators,the risk of dementia in older persons with multimorbidity status was higher than in those without multimorbidity status(OR=1.374,95% CI: 1.139 to 1.658);The risk of dementia in the older persons with hypertension,diabetes and cerebrovascular disease was higher than that in those without the disease(OR=1.214,1.397,1.362,95% CI: 1.012～1.456,1.110～1.759,1.097～1.691).(4)stratified analyses by hypertension and diabetes found that diabetes alone and hypertension diabetes comorbidity were associated with an increased risk of dementia(OR=1.532,1.791,95% CI: 1.091～2.145,1.232～2.323);hypertension cerebrovascular comorbidity was associated with an increased risk of dementia(OR=1.594,95% CI: 1.130 to 2.247).Conclusion: The prevalence of dementia is high among older people aged 65 and above in communities,and is significantly higher among rural older people than that among urban older people.The risk of dementia in the older adults with comorbidity,such as hypertension,diabetes and cerebrovascular disease is higher than that in those without chronic disease.Therefore,there is an urgent need to carry out interventions aimed at older people in the community with multimorbidity status to reduce the risk of dementia. |
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