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.
|Journal||Alzheimer's and Dementia|
|State||Accepted/In press - 2023|
Bibliographical noteFunding Information:
Lisa Ann Kirk Wiese received funding from National Institute of Health/National Institute on Aging (K01AG064047) and Florida Department of Health, Ed and Ethel Moore Research Foundation. Christine L. Williams was supported by NIH/NIA (R01 56AG064094). Allison Gibson received funding from National Institute of Health/National Institute on Aging (P30AG072946) and University of Kentucky, Sanders‐Brown Center on Aging. Amy R. Nelson received funding from NIH/NINDS (U19NS120384). Frederick P. Whiddon was supported by National Institute on Health/National Institutes of Aging (R00AG058780) and AlzOut. Aditi Gupta was supported by funding K23AG055555 and R61/33AG068483. Owen Carmichael was supported by NIH (grants AG078533, AG078558, AG07425801, AG077497, AG077000, AG067765, AG041200, AG062309, AG062200, AG069476). Allison Lindauer was supported by funding from NIH/NIA (R01AG067596; P30AG066518; P30AG042978). Rachel Peterson received funding from National Institute of Health/National Institute on Aging (4R00AG073457‐02). Elizabeth K. Rhodus was funded by National Institute of Health/National Institute on Aging (P30AG072946) and NIH/NIA (K23AG075262). Christina G. Wong was funded by Nevada Exploratory Alzheimer's Disease Research Center (under Award Number P20 AG068053) and the National Institute of General Medical Science (NIGMS) (under Award Number P20 GM109025). Megan Zuelsdorff was supported by funding (AARF‐18‐562958 and R03AG063303). Justin Miller received funding from Nevada Exploratory Alzheimer's Disease Research Center (under Award Number P20 AG068053) and the National Institute of General Medical Sciences (NIGMS) (under Award Number P20 GM109025). Sanne Franzen has received consulting fees from Biogen (paid to her organization). She has also received honoraria for lectures and speaking at panels. SF receives support through the ABOARD project, a public–private partnership funded by ZonMW (#73305095007) and Health‐Holland, Topsector Life Sciences & Health (PPP‐allowance; #LSHM20106). Caitlin N. Pope was supported by a research career development award (K12DA035150: Building Interdisciplinary Research Careers in Women's Health Program‐BIRCWH) from the National Institutes of Health Office of Research on Women's Health and the National Institute on Drug Abuse. Patricia C. Heyn was supported by National Institute of Health (5TR13AG072884‐02, NIH 1R13AT011146‐01, HHS, ACL, 90FPSG0063). Beth Prusaczyk was supported by NIH/NIA (K01AG071749). Ambar Kulshreshtha was supported by funding from NIH/NIA (K23 AG066931‐01A1). Veronica Yank received grants from National Institute of Health/National Institute on Aging (R01AG057855 and NIA R01AG072057). Lilah was supported by funding from NIH/NIA K01AG063895, NIH/NIA R21AG075291, and an Alzheimer's Association Research Grant (AARG‐21‐850963). Jon Corkey Amissa Corporation was supported by funding from the NIH /National Institute on Aging (1R43AG072981‐01A1) and National Science Foundation (#2127407). Ganesh M. Babulal was supported by the National Institute of Health/National Institute on Aging (grant numbers: R01 AG074302, R01 AG068183, R01 AG067428, R01 AG056466) and by the BrightFocus Foundation (A2021142S). Sheryl Magzamen was supported by funding from the NASA Health and Air Quality Applied Sciences Team.
© 2023 the Alzheimer's Association.
- community engagement
- community-based action
- facilitators and barriers to ADRD diagnosis and treatment
- global disparities
- health disparities
- location dynamics
- modifiable ADRD risk factors
- rural culture
ASJC Scopus subject areas
- Health Policy
- Developmental Neuroscience
- Clinical Neurology
- Geriatrics and Gerontology
- Cellular and Molecular Neuroscience
- Psychiatry and Mental health