Urban-rural disparity: temporal trends in dementia prevalence and the impact of demographic transition in Taiwan (2000–2020)

ObjectivesWhile the simultaneous rise of two major demographic trends—population aging and urbanization—has created significant global challenges, the long-term demographic impact on dementia prevalence remains unclear. This study aimed to examine temporal trends and urban–rural differences in dementia prevalence over a 20-year period (2000–2020) in Taiwan.MethodsThis study analyzed cross-sectional trends in dementia prevalence between urban and rural areas in Taiwan over five time points (2000, 2005, 2010, 2015, 2020) using the full population National Health Insurance database. Logistic regression models estimated adjusted odds ratios (AORs) for urban–rural comparisons of dementia prevalence, reporting AORs with 95% CI.ResultsUrbanization among older adults rose from 63.4% to 73.0%, alongside rising dementia prevalence in both settings. Initially higher in urban areas (2.79% vs. 2.56% in 2000), rural prevalence surpassed urban prevalence around 2010–2015 and widened by 2020 (8.23% rural vs. 6.81% urban). AORs for urban vs. rural prevalence declined from 1.02 (95% CI: 0.99–1.04) in 2000 to 0.95 (0.94–0.96) in 2020.DiscussionThis study highlights the significant impact of population aging and urbanization on dementia prevalence in Taiwan over two decades. Dementia prevalence increased markedly across both urban and rural areas, with rural areas surpassing urban prevalence between 2010 and 2015, likely due to decentralized healthcare and long-term care policies. These findings underscore the need for tailored dementia care strategies, especially in rural settings, to inform effective public health planning.