AUTHOR=Heng Xiaotian , Liu Xiaoting , Li Na , Lin Jie , Zhou Xiaoyan 

TITLE=Spatial disparity and factors associated with dementia mortality: A cross-sectional study in Zhejiang Province, China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1100960

DOI=10.3389/fpubh.2023.1100960

ISSN=2296-2565

ABSTRACT=Objective: There is evidence of spatial disparity in dementia mortality in China. Regional factors of physical and social features may be influencing this spatial disparity. However, there are few reports on dementia mortality in China, and the true extent of spatial disparity in dementia mortality across small regional localities is unclear. 
Methods: We used surveillance data on death reports from Alzheimer's disease and other forms of dementia in Zhejiang province from 2015–2019. We estimated the relative risk of dementia mortality using a Bayesian spatial model. We mapped predicted relative risk to visualize the risk of death from different types of dementia and to identify risk factors associated with dementia.
Results: A total of 30,398 deaths attributable to dementia as the underlying or related cause (multiple causes) were reported in 2015–2019. Counties and districts located in the southeast and west of Zhejiang province had significantly higher standardized mortality ratios than others. Counties and districts with a smaller proportion of residents aged 60 years or older, poorer economic status, insufficient health resources, and worse pollution had a higher risk of deaths due to dementia.
Conclusions: Higher risks of dementia mortality were found in counties and districts with poorer economic status, insufficient health resources, and worse pollution in Zhejiang. Our study adds new evidence on the association between socioeconomic and environmental factors and the mortality risk due to dementia.