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Aspects of Social Epidemiology in the Study of Alzheimer's Disease in Saguenay (Québec)/IMAGE Project*

Published online by Cambridge University Press:  29 November 2010

Michel Perron ,
Suzanne Veillette ,
Jean-François Emard ,
Jean-Pierre Thouez ,
Gilles Hébert ,
Jean Mathieu ,
Michel Beaudry ,
Andrée Cholette ,
Yves Robitaille  and
Rémi Bouchard
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Abstract

Based on a hypothesis that the cause of Alzheimer's Disease (AD) is multifactorial, we explored the possible links between the geographical distribution of 102 subjects diagnosed as “definite,” “probable” or “possible” cases at the onset of the disease and the social ecology of the Chicoutimi-Jonquière (CJ) urban area in the Saguenay region of Québec. We were also interested in the level of education of the 74 “definite” and “probable” cases. The use of factor analysis (principal components) and cluster analysis (Ward method) made it possible for us to identify socioeconomic zones and homogeneous social areas in CJ. The first results indicate that on the one hand, the male/female ratio of the cases differs statistically from that of the at-risk age group in the general population. The disease affects more women than men. On the other hand, there is significant social differentiation in CJ. Nevertheless, the 102 subjects are randomly distributed among the three socio-economic zones as well as among the eight social areas. Analysis of the geographical distribution of “definite” and “probable” cases also suggests a random distribution. The random nature of the distribution of subjects is confirmed by a very strong correspondence between the distribution of cases observed when counting them by enumeration area or census tract and Poisson's theoretical distribution. There was a significant difference between the subjects' level of education and that of the 65 years old and over in the reference population. A more in-depth case-control study might shed more light on this aspect.

Résumé

Se fondant sur l'hypothèse d'une origine multifactorielle de la maladie d'Alzheimer (MA), nous explorons les liens possibles entre la répartition géographique de 102 sujets diagnostiqués « définitifs, » « probables » et « possibles » à la survenue de la maladie, et l'écologie sociale de l'agglomération de Chicoutimi-Jonquière (ACJ) au Saguenay (Québec). Nous nous intéressons également au niveau de scolarité de 74 sujets « définitifs » et « probables ». Les méthodes de l'analyse factorielle (en composantes principales) et de l'analyse de groupement (méthode Ward) ont permis d'identifier des zones socio-économiques et des aires sociales homogènes dans l'ACJ. Les premiers résultats indiquent, d'une part, que le rapport de masculinité observé chez les cas de MA diffère statistiquement de celui du groupe d'âge à risque (45 ans et plus) dans la population saguenéenne. La maladie affecte plus de femmes que d'hommes. D'autre part, des analyses d'eacute;cologie sociale ont établi qu'il existe une différenciation sociale significative dans l'ACJ, soit trois zones socio-économiques et huit aires sociales distinctes. Cependant, les 102 sujets se répartissent aléatoirement dans l'ensemble de l'ACJ, quelque soit la zone socio-économique ou l'aire sociale considérée. L'analyse de la répartition géographique du groupe que constituent les cas « définitifs » et « probables » suggère également une distribution au hasard. Le caractère aléatoire de la répartition des sujets est confirmé par une très forte correspondance entre, d'une part, la distribution observée des cas par secteur de dénombrement ou par secteur de recensement et, d'autre part, la distribution théorique de Poisson. Il existe une différence significative entre la scolarité des sujets et celle de la population âgée de 65 ans et plus. Une étude plus approfondie, de type cas-témoins par exemple, devrait nous permettre éventuellement de faire la lumière à ce chapitre.

Keywords

Alzheimer's DiseaseSocial EpidemiologySaguenay (Quebec)Micro-scale.Maladie d'Alzheimerépidémiologie socialeSaguenay (Québec)micro-échelle.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 12 , Issue 3 , Fall/automne 1993 , pp. 382 - 398
Copyright
Copyright © Canadian Association on Gerontology 1993

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