Author(s) :

Gabriel Fang.

Volume/Issue :

Abstract :

Dementia is a growing public health burden in the United States, yet little is known about how risk factor profiles differ across various living settings. Using Round 13 of the National Health and Aging Trends Study (NHATS), this study compared correlates of dementia among community-dwelling and facility-residing older adults. Bivariate analyses were used to establish the baseline associations; CART (Classification and Regression Trees), a nonparametric method, was used to detect complex interactions and compare risk patterns in different settings. In both community and facility settings, bivariate analyses showed physical activity to be consistently associated with lower dementia prevalence. However, socioeconomic and demographic factors, as well as comorbidity burden, were significant correlates of dementia only in community settings, whereas co-residing with a spouse or others showed stronger and more pronounced associations in facility settings. CART models were also used to visualize shared and distinct patterns of interplay among multiple risk factors. Vigorous physical activity was the first splitting variable across settings, but subsequent branches differed: community trees emphasized medical conditions, income, and types of favorite activities, whereas facility trees highlighted co-residence with a spouse or others, along with walking exercise as a further differentiating factor. Such differentiated risk profiles stress the value of setting-specific approaches to understanding dementia risk.