Gender Differences in Cognitive Impairment among Rural Elderly in China
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Considerations
2.2. Setting and Participants
2.3. Data Collection
2.3.1. Demographic Information
2.3.2. Cognitive Function
2.3.3. Lifestyle Factors
2.3.4. Psychosocial Factors
2.3.5. Health-Related Factors
2.4. Data Analysis
3. Results
3.1. Demographic, Lifestyle, and Psychosocial Information
3.2. Health-Related Information
3.3. Cognitive Impairment inMales and Females
3.4. Univariate Analysis of Factors Associated withCognitive Impairment
3.5. Multivariate Analysis of Factors Associated withCognitive Impairment
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Male (n = 550), n (%) | Female (n = 700), n (%) | p | |
---|---|---|---|---|
Demographics | ||||
Age (years) | 65~ | 197(35.8) | 236(33.7) | 0.744 |
70~ | 175(31.8) | 218(31.1) | ||
75~ | 108(19.6) | 153(21.9) | ||
80~ | 70(12.7) | 93(13.3) | ||
Marital status | Married | 444(80.7) | 417(59.6) | 0.000 |
Divorced/Widowed | 106(19.3) | 283(40.4) | ||
Education | Illiteracy | 27(4.9) | 108(15.4) | 0.000 |
Primary school | 222(40.4) | 392(56.0) | ||
≥ Secondary school | 301(54.7) | 200(28.6) | ||
Income | Subsidies § | 219(39.8) | 412(58.9) | 0.000 |
Poverty | 115(20.9) | 145(20.7) | ||
Non-poverty | 216(39.3) | 143(20.4) | ||
Living situation | Alone | 46(8.4) | 93(13.3) | 0.000 |
With spouse | 243(44.2) | 212(30.3) | ||
2 generations | 33(6.0) | 61(8.7) | ||
≥3 generations | 228(41.5) | 334(47.7) | ||
Lifestyle | ||||
Regular house/farm work | No | 227(41.3) | 137(19.6) | 0.000 |
Yes | 323(58.7) | 563(80.4) | ||
Smoking | Never | 290(52.7) | 693(99.0) | 0.000 |
Ex-smoker | 33(6.0) | 6(0.9) | ||
Smoker | 227(41.3) | 1(0.1) | ||
Alcohol consumption | Never | 449(81.6) | 699(99.9) | 0.000 |
Sometimes | 79(14.4) | 1(0.1) | ||
Often | 22(4.0) | 0(0.0) | ||
Tea consumption | No | 386(70.2) | 659(94.1) | 0.000 |
Yes | 164(29.8) | 41(5.9) | ||
Psychosocial factors | ||||
Sleep quality | Good | 391(71.1) | 400(57.1) | 0.000 |
Moderate | 103(18.7) | 203(29.0) | ||
Poor | 56(10.2) | 97(13.9) | ||
Memory complaint | No | 120(21.8) | 96(13.7) | 0.000 |
Yes | 430(78.2) | 604(86.3) | ||
Social interactions in | Good | 172(31.3) | 239(34.1) | 0.513 |
neighborhood | Satisfactory | 361(65.6) | 443(63.3) | |
Poor | 17(3.1) | 18(2.6) | ||
Coping | Negative | 50(9.1) | 75(10.7) | 0.342 |
Positive | 500(90.9) | 625(89.3) |
Characteristics | Male (n = 550), n (%) | Female (n = 700), n (%) | p | |
---|---|---|---|---|
BMI (kg/m2) | Underweight | 44 (8.0) | 46 (6.6) | 0.188 |
Normal | 277 (50.4) | 328 (46.9) | ||
Overweight | 229 (41.6) | 326 (46.6) | ||
Waistline (cm) | Normal | 265 (48.2) | 244 (34.9) | 0.000 |
High | 285 (51.8) | 456 (65.1) | ||
Hearing | Poor | 171 (31.1) | 223 (31.9) | 0.780 |
Moderate | 219 (39.8) | 286 (40.9) | ||
Good | 160 (29.1) | 191 (27.3) | ||
Vision | Normal | 510 (92.7) | 635 (90.7) | 0.203 |
Weak | 40 (7.3) | 65 (9.3) | ||
Chronic disease | 0 | 151 (27.5) | 139 (19.9) | 0.005 |
1 | 204 (37.1) | 260 (37.1) | ||
2 | 130 (23.6) | 188 (26.9) | ||
≥3 | 65 (11.8) | 113 (16.1) | ||
Hypertension | No | 302 (54.9) | 335 (47.9) | 0.013 |
Yes | 248 (45.1) | 365 (52.1) | ||
Diabetes | No | 516 (93.8) | 629 (89.9) | 0.012 |
Yes | 34 (6.2) | 71 (10.1) | ||
Cerebrovascular disease | No | 501 (91.1) | 655 (93.6) | 0.099 |
Yes | 49 (8.9) | 45 (6.4) | ||
Heart disease | No | 407 (74.0) | 516 (73.7) | 0.909 |
Yes | 143 (26.0) | 184 (26.3) | ||
Hyperlipidemia | No | 522 (94.9) | 588 (84.0) | 0.000 |
Yes | 28 (5.1) | 112 (16.0) | ||
Renal disease | No | 521 (94.7) | 682 (97.4) | 0.013 |
Yes | 29 (5.3) | 18 (2.6) | ||
Traumatic brain injury | No | 496 (90.2) | 657 (93.9) | 0.016 |
Yes | 54 (9.8) | 43 (6.1) | ||
ADL dependence | No | 515 (93.6) | 646 (92.3) | 0.357 |
Yes | 35 (6.4) | 54 (7.7) | ||
Physical ADL dependence | No | 304 (55.3) | 241 (34.4) | 0.000 |
Yes | 246 (44.7) | 459 (65.6) | ||
IADL dependence | No | 392 (71.3) | 449 (64.1) | 0.008 |
Yes | 158 (28.7) | 251 (35.9) |
Subgroup | Male (n = 550) | Female (n = 700) | p | ||
---|---|---|---|---|---|
Individuals, N | Cases, n (%) | Individuals, N | Cases, n (%) | ||
Overall | 550 | 220 (40.0) | 700 | 316 (45.1) | 0.068 |
Age(years) | |||||
65~ | 197 | 70 (35.5) | 236 | 70 (29.7) | 0.193 |
70~ | 175 | 61 (34.9) | 218 | 84 (38.5) | 0.453 |
75~ | 108 | 49 (45.4) | 153 | 96 (62.7) | 0.005 |
80~ | 70 | 40 (57.1) | 93 | 66 (71.0) | 0.067 |
Education | |||||
Illiteracy | 27 | 13 (48.1) | 108 | 80 (74.1) | 0.009 |
Primary school | 222 | 66 (29.7) | 392 | 139 (35.5) | 0.148 |
≥Secondary school | 301 | 141 (46.8) | 200 | 97 (48.5) | 0.716 |
Marital status | |||||
Married | 444 | 171 (38.5) | 417 | 160 (38.4) | 0.965 |
Divorced/Widowed | 106 | 49 (46.2) | 283 | 156 (55.1) | 0.118 |
Income | |||||
Subsidies § | 219 | 100 (45.7) | 412 | 209 (50.7) | 0.226 |
Poverty | 115 | 39 (33.9) | 145 | 51 (35.2) | 0.832 |
Non-poverty | 216 | 81 (37.5) | 143 | 56 (39.2) | 0.751 |
Living alone | |||||
Yes | 46 | 19 (41.3) | 93 | 51 (54.8) | 0.133 |
No | 504 | 201 (39.9) | 607 | 265 (43.7) | 0.204 |
Variables | Male (n = 550) | Female (n = 700) | |||
---|---|---|---|---|---|
Prevalence (95%CI) | OR (95%CI) | Prevalence (95%CI) | OR (95%CI) | ||
Total | 40.0 (35.9–44.1) | - | 45.1 (41.4–48.8) | - | |
Age (years) | 65~ (ref.) | 35.5 (28.8–42.3) | 29.7 (23.8–35.5) | ||
70~ | 34.9 (27.7–42.0) | 0.971 (0.634–1.487) | 38.5 (32.0–45.0) | 1.487 (1.006–2.197) | |
75~ | 45.4 (35.8–54.9) | 1.507 (0.934–2.431) | 62.7 (55.0–70.5) | 3.994 (2.597–6.144) | |
80~ | 57.1 (45.3–60.0) | 2.419 (1.387–4.218) | 71.0 (61.6–80.4) | 5.797 (3.420–9.826) | |
Marital status | Married (ref.) | 38.5 (34.0–43.1) | 38.4 (33.7–43.1) | ||
Divorced/Widowed | 46.2 (36.6–55.9) | 1.372 (0.895–2.103) | 55.1 (49.3–61.0) | 1.973 (1.452–2.680) | |
Education | Illiteracy (ref.) | 48.1 (28.0–68.3) | 74.1 (65.7–82.5) | ||
Primary school | 29.7 (23.7–35.8) | 0.456 (0.203–1.022) | 35.5 (30.7–40.2) | 0.192 (0.119–0.310) | |
≥ Secondary school | 46.8 (41.2–52.5) | 0.949 (0.432–2.087) | 48.5 (41.5–55.5) | 0.330 (0.198–0.550) | |
Income | Subsidies§(ref.) | 45.7 (39.0–52.3) | 50.7 (45.9–55.6) | ||
Poverty | 33.9 (25.1–42.7) | 0.611 (0.382–0.976) | 35.2 (27.3–43.0) | 0.527 (0.356–0.780) | |
Non-poverty | 37.5 (31.0–44.0) | 0.714 (0.487–1.047) | 39.2 (31.1–47.3) | 0.625 (0.424–0.921) | |
Regular house/farm work | No (ref.) | 48.0 (41.5–54.6) | 63.5 (55.3–71.7) | ||
Yes | 34.4 (29.2–39.6) | 0.567 (0.401–0.802) | 40.7 (36.6–44.7) | 0.394 (0.268–0.580) | |
Smoking | Never (ref.) | 42.8 (37.0–48.5) | 45.0 (41.3–48.7) | ||
Ex-smoker | 42.4 (24.6–60.2) | 0.986 (0.476–2.044) | 66.7 (12.5–120.9) | 2.442 (0.444–13.422) | |
Smoker | 36.1 (29.8–42.4) | 0.757 (0.530–1.082) | 0.0 | 0.000 | |
Alcohol consumption | Never (ref.) | 42.8 (38.2–47.4) | 45.2 (41.5–48.9) | ||
Sometimes | 27.8 (17.7–38.0) | 0.517 (0.305–0.874) | 0.0 | 0.000 | |
Often | 27.3 (7.1–47.5) | 0.502 (0.193–1.307) | - | - | |
Tea consumption | No (ref.) | 43.3 (38.3–48.2) | 45.4 (41.6–49.2) | ||
Yes | 32.3 (25.1–39.6) | 0.626 (0.426–0.919) | 41.5 (25.7–57.2) | 0.853 (0.450–1.617) | |
Sleep quality | Good (ref.) | 39.6 (34.8–44.5) | 42.3 (37.4–47.1) | ||
Moderate | 41.7 (32.1–51.4) | 1.091 (0.702–1.696) | 50.7 (43.8–57.7) | 1.408 (1.003–1.976) | |
Poor | 39.3 (26.1–52.5) | 0.985 (0.555–1.748) | 45.4 (35.3–55.4) | 1.135 (0.726–1.773) | |
Memory complaint | No (ref.) | 35.8 (27.1–44.5) | 29.2 (19.9–38.4) | ||
Yes | 41.2 (36.5–45.8) | 1.253 (0.823–1.906) | 47.7 (43.7–51.7) | 2.213 (1.386–3.535) | |
Living situation | Alone (ref.) | 41.3 (26.5–56.1) | 54.8 (44.5–65.1) | ||
With spouse | 37.9 (31.7–44.0) | 0.866 (0.456–1.645) | 38.2 (31.6–44.8) | 0.509 (0.311–0.834) | |
2 generations | 24.2 (8.8–39.7) | 0.455 (0.169–1.223) | 44.3 (31.4–57.1) | 0.654 (0.342–1.252) | |
≥3 generations | 44.3 (37.8–50.8) | 1.130 (0.594–2.149) | 47.0 (41.6–52.4) | 0.730 (0.460–1.159) | |
Social interactions in neighborhood | Good (ref.) | 40.1 (32.7–47.5) | 43.9 (37.6–50.3) | ||
Satisfactory | 38.2 (33.2–43.3) | 0.924 (0.637–1.339) | 45.6 (40.9–50.3) | 1.070 (0.779–1.468) | |
Poor | 76.5 (54.0–99.0) | 4.851 (1.519–15.497) | 50.0 (24.4–75.6) | 1.276 (0.489–3.328) | |
Coping | Negative (ref.) | 48.0 (33.7–62.3) | 58.7 (47.3–70.1) | ||
Positive | 39.2 (34.9–43.5) | 0.698 (0.390–1.251) | 43.5 (39.6–47.4) | 0.543 (0.334–0.883) |
Variables | Male (n = 550) | Female (n = 700) | |||
---|---|---|---|---|---|
Prevalence (95%CI) | OR (95%CI) | Prevalence (95%CI) | OR (95%CI) | ||
BMI (kg/m2) | Underweight | 50.0 (34.6–65.4) | 60.9 (46.2–75.5) | ||
Normal | 40.1 (34.3–45.9) | 0.669 (0.353–1.266) | 45.7 (40.3–51.2) | 0.542 (0.288–1.018) | |
Overweight | 38.0 (31.7–44.3) | 0.613 (0.320–1.172) | 42.3 (36.9–47.7) | 0.472 (0.251–0.887) | |
Waistline (cm) | Normal | 40.8 (34.8–46.7) | 46.3 (40.0–52.6) | ||
High | 39.3 (33.6–45.0) | 0.941 (0.669–1.324) | 44.5 (39.9–49.1) | 0.930 (0.681–1.271) | |
Hearing | Poor (ref.) | 36.3 (28.7–43.8) | 34.6 (27.7–41.4) | ||
Moderate | 31.5 (25.3–37.7) | 0.477 (0.307–0.741) | 38.8 (33.1–44.5) | 0.319 (0.213–0.477) | |
Good | 54.4 (46.8–61.9) | 0.386 (0.255–0.584) | 62.3 (55.9–68.7) | 0.383 (0.267–0.550) | |
Vision | Normal | 38.4 (34.2–42.7) | 42.2 (38.4–46.1) | ||
Weak | 60.0 (44.1–75.9) | 2.403 (1.245–4.637) | 73.8 (62.9–84.8) | 3.867 (2.175–6.872) | |
Chronic disease | 0 (ref.) | 35.1 (27.4–42.8) | 36.0 (27.9–44.0) | ||
1 | 40.7 (33.9–47.5) | 1.268 (0.821–1.961) | 48.1 (42.0–54.2) | 1.648 (1.079–2.517) | |
2 | 39.2 (30.7–47.7) | 1.194 (0.735–1.940) | 47.3 (40.1–54.5) | 1.600 (1.021–2.508) | |
≥ 3 | 50.8 (38.3–63.3) | 1.907 (1.057–3.440) | 46.0 (36.7–55.3) | 1.517 (0.914–2.519) | |
Hypertension | No (ref.) | 39.4 (33.9–44.9) | 41.8 (36.5–47.1) | ||
Yes | 40.7 (34.6–46.9) | 1.057 (0.750–1.488) | 48.2 (43.1–53.4) | 1.297 (0.962–1.749) | |
Diabetes | No (ref.) | 39.0 (34.7–43.2) | 44.7 (40.8–48.6) | ||
Yes | 55.9 (38.3–73.5) | 1.985 (0.986–3.996) | 49.3 (37.4–61.2) | 1.204 (0.737–1.968) | |
Cerebrovascular disease | No (ref.) | 38.9 (34.6–43.2) | 44.6 (40.8–48.4) | ||
Yes | 51.0 (36.5–65.5) | 1.635 (0.908–2.944) | 53.3 (38.2–68.5) | 1.421 (0.775–2.603) | |
Heart disease | No (ref.) | 39.6 (34.8–44.3) | 43.8 (39.5–48.1) | ||
Yes | 41.3 (33.1–49.4) | 1.073 (0.728–1.581) | 48.9 (41.6–56.2) | 1.229 (0.877–1.721) | |
Hyperlipidemia | No (ref.) | 40.0 (35.8–44.3) | 46.3 (42.2–50.3) | ||
Yes | 39.3 (20.0–58.6) | 0.969 (0.445–2.110) | 39.3 (30.1–48.5) | 0.752 (0.498–1.135) | |
Renal disease | No (ref.) | 39.9 (35.7–44.1) | 44.7 (41.0–48.5) | ||
Yes | 41.4 (22.3–60.4) | 1.062 (0.497–2.270) | 61.1 (36.2–86.1) | 1.942 (0.744–5.071) | |
Traumatic brain injury | No (ref.) | 38.7 (34.4–43.0) | 44.4 (40.6–48.3) | ||
Yes | 51.9 (38.1–65.6) | 1.705 (0.971–2.996) | 55.8 (40.3–71.3) | 1.579 (0.848–2.939) | |
ADL dependence | No (ref.) | 38.1 (33.9–42.3) | 42.7 (38.9–46.5) | ||
Yes | 68.6 (52.4–84.8) | 3.551 (1.702–7.409) | 74.1 (62.0–86.1) | 3.830 (2.043–7.179) | |
Physical ADL dependence | No (ref.) | 34.5 (29.2–39.9) | 33.2 (27.2–39.2) | ||
Yes | 46.7 (40.5–53.0) | 1.664 (1.179–2.348) | 51.4 (46.8–56.0) | 2.130 (1.539–2.947) | |
IADL dependence | No (ref.) | 35.7 (31.0–40.5) | 39.4 (34.9–44.0) | ||
Yes | 50.6 (42.8–58.5) | 1.846 (1.270–2.684) | 55.4 (49.2–61.6) | 1.907 (1.395–2.607) |
Variables | Male (n-550) | Female (n = 700) | |
---|---|---|---|
OR (95% CI) | OR (95% CI) | ||
Age (years) | 65~(ref.) | ||
70~ | 0.894 (0.559–1.430) | 1.133 (0.739–1.736) | |
75~ | 1.179 (0.690–2.014) | 2.793 (1.729–4.511) | |
80~ | 2.357 (1.255–4.428) | 2.070 (1.061–4.036) | |
Education | Illiteracy (ref.) | ||
Primary school | 0.754 (0.304–1.866) | 0.352 (0.199–0.623) | |
≥ Secondary school | 2.156 (0.868–5.355) | 0.851 (0.454–1.597) | |
Tea consumption | No (ref.) | - | |
Yes | 0.656 (0.431–0.999) | ||
Social interactions in neighborhood | Good (ref.) | - | |
Satisfactory | 0.942 (0.625–1.422) | ||
Poor | 4.860 (1.424–16.583) | ||
Hearing | Good (ref.) | ||
Moderate | 0.830 (0.516–1.334) | 0.903 (0.589–1.382) | |
Poor | 2.027 (1.211–3.393) | 2.110 (1.321–3.369) | |
Vision | Normal (ref.) | - | |
Weak | 2.024 (1.051–3.897) | ||
Diabetes | No (ref.) | ||
Yes | 2.344 (1.083–5.076) | - | |
ADL dependence | No (ref.) | ||
Yes | 3.267 (1.459–7.314) | 2.041 (0.976–4.270) | |
Physical ADL dependence | No (ref.) | - | |
Yes | 1.613 (1.121–2.322) |
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Wang, J.; Xiao, L.D.; Wang, K.; Luo, Y.; Li, X. Gender Differences in Cognitive Impairment among Rural Elderly in China. Int. J. Environ. Res. Public Health 2020, 17, 3724. https://doi.org/10.3390/ijerph17103724
Wang J, Xiao LD, Wang K, Luo Y, Li X. Gender Differences in Cognitive Impairment among Rural Elderly in China. International Journal of Environmental Research and Public Health. 2020; 17(10):3724. https://doi.org/10.3390/ijerph17103724
Chicago/Turabian StyleWang, Jing, Lily Dongxia Xiao, Kai Wang, Yan Luo, and Xiaomei Li. 2020. "Gender Differences in Cognitive Impairment among Rural Elderly in China" International Journal of Environmental Research and Public Health 17, no. 10: 3724. https://doi.org/10.3390/ijerph17103724