Introduction The relationship between dementia and socioeconomic deprivation is unclear. This study examined the association between social position and dementia, and determined the prevalence of dementia diagnosed using the 10/66 algorithms in people with high levels of absolute poverty but low levels of cardiovascular risk factors and depression.
Methods Prospective cohort study of 1766 elders in rural and urban community-dwellings in Anhui, China. Standardised mental status measures were administered and socioeconomic and risk factors were characterised at baseline. At 6.2-year follow-up, dementia cases were identified using the 10/66 algorithms, causes of death and reports by psychiatrists.
Results The world age-standardised prevalence of dementia diagnosed by the 10/66 algorithms was 5.41% (95% CI (4.26% to 6.55%)); in men 4.38% (2.88% to 5.89%) and in women 6.44% (4.76% to 8.13%). The risk of dementia significantly and independently increased with age, lower educational level, uncontrolled hypertension, not watching television, feeling lonely and hearing problems. Compared to those that achieved an educational level of ≥ secondary school and middle income participants, those with lower educational attainment and in the lowest or highest income groups had a higher risk of dementia; multiple adjusted OR (AOR) were 2.99 (1.24 to 7.23) and 3.30 (1.09 to 9.97) respectively. Business/non-labouring participants with educational levels of ≤ primary school had the highest risk of dementia (AOR 3.80 (1.43 to 10.1)) compared to other combinations of occupational class and educational level.
Conclusions Increasing income and minimising the gap in income between poor and rich may reduce the epidemic of dementia in China. Increasing levels of education and TV watching could be an efficient measures to prevent dementia in developing countries.