Rural residence and risk of dementia

We sought to determine whether residence in a rural region is associated with a higher risk of dementia and a higher risk of developing dementia over a 5-year period than residence in an urban region.

This was a secondary analysis of a prospective cohort study. In 1991 and 1992, 1751 adults aged 65 years and older and residing in the community were sampled from a representative population-based registry, which included the entire province (time 1). Follow-up occurred 5 years later (time 2). Age, sex and education were selfreported. Rurality was determined by the population of the Census subdivision, with a population greater than 19 999 considered urban. Cognition was assessed using the Modified Mini-Mental State Examination, with those scoring below 78 invited to undergo a clinical examination to determine the presence of dementia. Cross-sectional analyses were conducted for participants with complete data at time 1. Prospective analyses were conducted for participants with normal cognition at time 1, who had complete data and survived until time 2. Logistic regression models were constructed for the outcome of dementia at times 1 and 2.

Residence in a rural region was not associated with dementia in the cross-sectional analyses (adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 0.61-1.91) and did not predict dementia 5 years later (adjusted OR 1.05, 95% CI 0.66-1.68).

We found no difference in the risk of dementia among older adults living in urban and rural regions of Manitoba.