The Investigation And Analysis Of The Gender Differences In Alzheimer In Rural Areas

Research Background:A lot of studies suggest that women have higher risk of suffering from dementia than men, especially in AD types of dementia, while some studies show that there is no significant gender differences. Analysis indicates that women have higher AD incidence, and another study showed that only the women who are more than 90 years old have higher AD incidence. Meanwhile, some studies show that men have higher MCI incidence than women which seems to contradicting the past researches. Therefore, gender differences on the AD still have large controversy. Rural population compared with city community people have lower education level, poorer medical treatment level, less cognitive activity, more physical activity, etc. So far, it is lack of specific clinical data about epidemiological features of AD and the gender difference in AD in rural Shandong province.Research Objectives:1. This research mainly aims at whether there is gender differences in the prevalence of AD in rural population of Shandong province.2. Then further explore the relationship between gender and AD, and possible related factors.Research Methods:This study was a cross-sectional study located in Yanlou county of Shandong Province and was divided into two stages. In August 2014, we started the first stage and collected the demographic data and basic information of people aged 65-85. The people with high risks of developing into AD were identified. The second phase was in December 2014. In this stage, we provide high-risk groups identified in the first stage with detailed assessment include:history taking, evaluation daily living ability, neurological examination and neuropsychological assessment. The neuropsychological tests include assessments of cognitive domains in learning and memory, visual-spatial, execution, attention, language. Through the inspection and assessment of results, we get the diagnosis and differential diagnosis of AD.Research results:After the the investigation, we totally surveyed 2377 elderly people. Among them,127 patients were diagnosed of AD,1908 cases of normal cognition,247 cases of amnestic mild cognitive impairment and 94 cases of other types of dementia or cognitive impairment. AD prevalence rate of male was 2.9%, while the prevalence rate of female was 7.4%. The prevalence of female is higher than men, and there was significant difference between them (χ2= 24.11, P<0.05).Then, we selected the AD group for the disease group and the normal cognitive group for the control to conduct the case-control study. Results show that women suffer a higher risk of AD than men and there is a significant difference (OR= 2.872, x2= 26.883, P<0.05). Then we choose M-H stratified analysis to evaluate the possible factors affected the relationship between gender and AD. After stratified by education, the odds ratio is 1.444, significantly less than before. There is no significant difference in the relationship between different gender and AD (x2= 2.264, P= 0.132> 0.05). Respectively, after stratification by age, occupation, marital status, hypertension, hyperlipidemia, diabetes, smoking, drinking, the results show that these factors are not confounding factors between gender and the AD (OR=2.907,2.513, 2.753,2.822,2.867,2.854,3.169,2.389), and there are still significant differences between gender and post-stratification AD (P<0.05). Finally, logistics regression after univariate analysis proved that sex couldn’t not constitute an independent risk factor for AD.Conclusion:1. There was a significant gender difference in AD prevalence of people aged 65-85 in this rural area.2. Women suffer a higher risk of AD than men.3. Gender differences in AD prevalence, or the correlation between AD and sex, largely due to the low education among female.4. Age, occupation, marital status, hypertension, hyperlipidemia, diabetes, smoking and drinking can not be considered as confounding factors that influence the relationship between gender and AD.5. The correct understanding of gender differences in AD can not only give new viewpoint of AD, but also be beneficial to the development of individual and gender-specific therapy.