COMPARATIVE-STUDY OF THE PREVALENCE OF DEMENTIA IN 2 SICILIAN COMMUNITIES WITH DIFFERENT PSYCHOSOCIAL BACKGROUNDS

The role of education and psychosocial environment as factors for the development of dementia is controversial. We carried out a comparative study on the prevalence of dementia among persons over 74 years of ag e in two Sicilian municipalities, Troina and S. Agata Militello, with different psychosocial backgrounds. A two-stage survey was performed f or both samples. In stage I the Mini Mental Status Examination (previo usly validated for the cutoff score with 100% sensitivity and the high est specificity) was used to screen a 50% random sample of persons ove r 74 years of age. In those referred to stage 2, the diagnosis of deme ntia was made by a neurologist according to DSM-III R. Three hundred a nd sixty-five subjects were recruited in Troina and 408 in S. Agata Mi litello. The minimal estimates of dementia prevalence were 21.9% (21.9 % men, 21.9% women) in Troina and 28.4% (26.6% men, 29.6% women) in S. Agata Militello. Although intrasample multiple logistic exact analysi s (demented vs. unproven demented) indicated poor formal education and manual occupation as risk factors for dementia, and intersample compa rison (Troina vs. S. Agata Militello) showed that these variables were more frequent in Troina, we did not find a higher prevalence of demen tia in this community. We discuss this apparently ambiguous result and suggest that psychosocial and cultural variables might be considered multiple interacting factors with different protective or predisposing roles for dementia. Higher or lower risk could then be the result of this complex interaction in different populations.