Global rural health disparities in Alzheimer's disease and related dementias: State of the science

Authors

Lisa Ann Kirk Wiese, Florida Atlantic University
Allison Gibson, University of Kentucky
Marc Aaron Guest, Edson College of Nursing and Health Innovation
Amy R. Nelson, University of South Alabama College of Medicine
Raven Weaver, Washington State University Pullman
Aditi Gupta, University of Kansas School of Medicine
Owen Carmichael, Pennington Biomedical Research Center
Jordan P. Lewis, University of Minnesota Medical School
Allison Lindauer, Oregon Health & Science University
Samantha Loi, Royal Melbourne Hospital
Rachel Peterson, University of Montana
Kylie Radford, UNSW Sydney
Elizabeth K. Rhodus, University of Kentucky
Christina G. Wong, Cleveland Clinic Lou Ruvo Center for Brain Health
Megan Zuelsdorff, University of Wisconsin–Madison School of Nursing
Ladan Ghazi Saidi, University of Nebraska at Kearney
Esmeralda Valdivieso-Mora, Universidad Centroamericana “José Simeón Cañas”
Sanne Franzen, Erasmus MC
Caitlin N. Pope, University of Kentucky
Timothy S. Killian, University of Arkansas
Hom L. Shrestha, Université Laurentienne
Patricia C. Heyn, Marymount University
Ted Kheng Siang Ng, Arizona State University Downtown Phoenix Campus
Beth Prusaczyk, Washington University School of Medicine in St. Louis
Samantha John, University of Nevada, Las Vegas
Ambar Kulshreshtha, Emory University School of Medicine
Julia L. Sheffler, Florida State University College of Medicine
Lilah Besser, University of Miami Leonard M. Miller School of Medicine
Valerie Daniel, University of Miami Leonard M. Miller School of Medicine
Magdalena I. Tolea, University of Miami Leonard M. Miller School of Medicine
Justin Miller, Cleveland Clinic Lou Ruvo Center for Brain Health
Christine Musyimi, Africa Mental Health Research & Training Foundation
Jon Corkey, AMISSA, INC.
Veronica Yank, UCSF School of Medicine

Document Type

Article

Publication Date

9-1-2023

Abstract

INTRODUCTION: Individuals living in rural communities are at heightened risk for Alzheimer's disease and related dementias (ADRD), which parallels other persistent place-based health disparities. Identifying multiple potentially modifiable risk factors specific to rural areas that contribute to ADRD is an essential first step in understanding the complex interplay between various barriers and facilitators. METHODS: An interdisciplinary, international group of ADRD researchers convened to address the overarching question of: “What can be done to begin minimizing the rural health disparities that contribute uniquely to ADRD?” In this state of the science appraisal, we explore what is known about the biological, behavioral, sociocultural, and environmental influences on ADRD disparities in rural settings. RESULTS: A range of individual, interpersonal, and community factors were identified, including strengths of rural residents in facilitating healthy aging lifestyle interventions. DISCUSSION: A location dynamics model and ADRD-focused future directions are offered for guiding rural practitioners, researchers, and policymakers in mitigating rural disparities. HIGHLIGHTS: Rural residents face heightened Alzheimer's disease and related dementia (ADRD) risks and burdens due to health disparities. Defining the unique rural barriers and facilitators to cognitive health yields insight. The strengths and resilience of rural residents can mitigate ADRD-related challenges. A novel “location dynamics” model guides assessment of rural-specific ADRD issues.

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