Prevalence and influencing factors of dementia in the elderly iranian population: a cross-sectional study

The global rise in dementia prevalence, a major neurocognitive disorder, poses a significant challenge to aging populations. This study aimed to determine the prevalence of dementia and its associated risk factors among community-dwelling elderly in selected provinces of Iran.

A cross-sectional study was conducted from October 2022 to March 2024, enrolling 58,228 individuals aged 60-75 years from two provinces (Qazvin and Yazd) selected via multi-stage, stratified random sampling. A multi-stage diagnostic protocol was employed, using validated Persian versions of the Geriatric Depression Scale (GDS), Abbreviated Mental Test Score (AMTS), Mini-Mental State Examination (MMSE), Functional Assessment Staging (FAST), and Montreal Cognitive Assessment (MoCA) with standardized cut-offs. Multivariable logistic regression was used to identify factors associated with dementia.

After exclusions, the final analytical sample was 56,456 participants. The overall prevalence of dementia was 10.1%. Prevalence was significantly higher in women (13.2%) than in men (7.0%). In the adjusted model, female gender (aOR: 2.04, 95% CI: 1.92-2.15), older age (70-79 years vs. 60-64 years, aOR: 1.70, 95% CI: 1.59-1.82), widowhood (aOR: 1.50, 95% CI: 1.05-2.16), and lower educational attainment (illiterate vs. academic, aOR: 6.55, 95% CI: 5.43-7.91) were significantly associated with higher odds of dementia.

This large-scale study reveals a substantial burden of dementia in the studied Iranian provinces. The identified risk factors, including female sex, advanced age, widowhood, and low education, highlight vulnerable subgroups and underscore the urgent need for targeted public health strategies focused on early detection, risk reduction, and support systems for the elderly in Iran.