Objective: The aim of this study was to compare the prevalence rates of dementia in an urban and a rural population. Design: We used data gathered from a longitudinal study carried out in two areas in Sweden: the Kungsholmen district in central Stockholm, and the municipality of Nordanstig in Hälsingland. The study population consisted of all persons aged 75+ years registered in the two areas, whether living at home or in institutions. Materials and Methods: All subjects were clinically examined by physicians and interviewed for socio-demographic characteristics by nurses. Blood tests were also carried out. The DSM III-R criteria for dementia were followed. Age- and gender-specific prevalence figures, and gender- and education-adjusted odds ratios (OR) were calculated. Results: In the urban area 6.2 % had died and 2.3% moved before the examination. The corresponding figures for the rural area were 13.6% and 0.1%. Of the remaining subjects 1222 persons (87.7%) were clinically examined from the urban area and 919 (92.3%) from the rural area. We found 19.9% and 19.7% with clinically definite dementia and 6.1% and 10.7% with questionable dementia in the urban and rural area respectively. In the urban area Alzheimer’s Disease (AD) contributed to 72.8%, and Vascular Dementia (VaD) to 16.0%. In the rural area AD contributed to 66.3% and VaD to 17.1%. The prevalence of dementia increased from 12.4% in the 75-84 old subjects to 30.4% among 85+ old persons in the urban area. In the rural area the dementia prevalence increased from 16.2% in the 75-84 old subjects to 28.3% among 85+ old persons. The OR for having clinically definite dementia in the rural area compared to the urban area was 1.4 (1.0-1.8) in the 75-84 years old subjects and 0.9 (0.7-1.3) in the age group 85+. This effect disappeared when controlled for gender and education. The OR (95% CI) for having clinically definite dementia in the urban population were 2.9 (2.2-4.0) for older age, 1.3 (0.9-1.9) for female gender and 1.9 (1.4-2.6) for low education. The corresponding OR for the rural population were 2.0 (1.4-2.9), 1.1 (0.7-1.5), and 1.5 (0.4-5.3). Conclusion: We found no difference in dementia prevalence between the urban and rural areas. The difference that was detected with the crude OR was mainly due to the difference in education in the two areas.
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