Dementia In Rural Communities Research Articles

Nevada exploratory Alzheimer’s disease research center: Advancing dementia care in rural communities

AbstractBackgroundPeople with MCI and AD living in rural areas represent an understudied and underserved population in the broader AD landscape. Very little works have been done on rural cohorts by NIA‐designated Alzheimer’s Disease Research Centers (ADRCs) in the past. The Nevada Exploratory ADRC (NVeADRC) is specifically set to study AD and related dementias in rural individuals, and to systematically generate novel data on the clinical features of AD, clinical outcomes, and social determinants of health.MethodThe leading scientific objectives of the NVeADRC are to: 1) understand the occurrence of AD and optimize treatment in underserved rural settings; 2) examine risk factors associated with the development of AD in rural areas; and 3) evaluate the trajectories and progression of AD in rural versus urban communities. The NVeADRC will deploy a top‐down strategy to: 1) establish a network of stakeholders and medical partners to increase awareness of dementia in rural communities and enroll rural participants in our research cohort; 2) develop a research enterprise for longitudinal studies on dementia in rural populations; 3) progressively implement a research infrastructure rooted in technology to facilitate standardized clinical data collection from patients in rural areas.ResultThe data collected will be part of the National Alzheimer’s Coordinating Center (NACC) and shared with the larger scientific community to ultimately to improve healthcare for patients in rural areas. Target recruitment for the NVeADRC include 20 Mild Cognitive Impairment, 40 dementia due to Alzheimer’s disease and 40 cognitively normal subjects. In addition to the Uniform Data Set 3.0, we intend to collect volumetric MRI, biofluids (blood, saliva, and cerebrospinal fluid), as well as, a series of both static and dynamic social determinants of health on study subjects and their partners. All participants will be followed to voluntary withdrawal or autopsy.ConclusionThe NVeADRC represents a unique, high impact entity within the ADRC network, and will generate high‐quality biomedical data that advance AD/ADRD research on individuals living in underserved rural communities. As we grow our project, we intend to share biospecimens and data with the scientific community.

Optimizing hospital-to-home transitions for older persons in rural communities: a participatory, multimethod study protocol

BackgroundTransitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities.MethodsIn this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15–20 people with dementia and 15–20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions’ acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8–10 healthcare providers per focus group) will be held for a total of 8–12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings.DiscussionFindings will (1) include a set of acceptable interventions for rural transitional care that promote older patients’ functioning and family-caregivers’ ability to support patients’ functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.

Sex Differences in Cardiovascular Disease and Cognitive Dysfunction in Rural West Elderly Texans.

Background:The prevalence of cognitive dysfunction increases in elderly due to cardiovascular disease related risk factors in rural communities like West Texas.Objective:The purpose of this study was to find risk factors of cardiovascular disease (CVD) related to cognitive dysfunction and their impact on elderly adults in rural West Texans.Methods:Statistical methods such as Pearson’s chi-squared and a multinomial logistic regression were utilized to analyze data. We used SPSS software to detect and understand the nature of the risk factors.Results:A summary of statistics was obtained by using Pearson’s chi-squared test for categorical variables. CVD, diabetes mellitus, and depression were significantly associated with cognitive dysfunction for both males and females (p = 0.0001), whereas anxiety was found to be significantly associated with cognitive dysfunction for females (p = 0.0001). Age group and race/ethnicity were significantly associated with cognitive dysfunction for both males and females (p = 0.0001). By performing a multinomial logistic regression method and controlling for confounders, the significant risk factors (p < 0.05)— age (65– 84 years), diabetes, and memory loss for age-associated cognitive impairment; diabetes for cognitive impairment no dementia; age (65– 84, ≥85 years), CVD, diabetes, depression, memory loss, non-Hispanic Whites, and Black/African-Americans for mild cognitive impairment; and age, memory loss, non-Hispanic Whites, Black/African-Americans, and male gender were found for dementia.Conclusion:CVD related risk factors in developing cognitive dysfunction exist and integrating such risk variables may guide relevant policy interventions to reduce Alzheimer’s incidence or dementia in rural communities in West Texans.

Interventions to Reduce Stigma of Dementia: First Insights From a Rural Community-Based Participatory Study

Age is the greatest risk factor for dementia, and the number of rural older adults is rising. Although dementia-related stigma is widely documented, few studies focus on ways to reduce stigma, especially within rural communities. This late breaker presentation aims to: 1) explore the contributing factors of dementia-related stigma in rural communities; and 2) identify interventions to reduce stigma of dementia in rural communities. Drawing on a community-based participatory approach, data were collected through semi-structured interviews with 18 older adults, and a focus group with 7 community leaders in rural Saskatchewan, Canada. Thematic analysis was used to identify key themes and patterns within the data. Contributing factors of dementia-related stigma ranged from fear to lack of dementia knowledge. Several anti-stigma interventions were identified including: forming support groups; hosting educational workshops; inviting guest speakers with dementia; talking openly about dementia; learning more about dementia; asking questions; sharing your lived-experiences; being inclusive; developing inter-generational programs; and avoiding assumptions and hurtful jokes. As the rural population ages, there is a growing need for interventions, programs, and policies to address stigma of dementia. Engaging in rural partnerships and collaborative research is essential to developing community-informed strategies to reduce dementia-related stigma and improve the quality of life for people with dementia.

Cerebrovascular Correlates of Dementia in Rural Communities - The Three Villages Study

Cerebrovascular Correlates of Dementia in Rural Communities - The Three Villages Study

Providing Care for Persons with Dementia in Rural Communities: Informal Caregivers’ Perceptions of Supports and Services

ABSTRACTDementia is one of the costliest and most time-consuming diseases among older persons. Although informal caregivers provide the majority of care for persons with dementia, little is known about the self-perceived need for social services of caregivers of persons with dementia within rural areas. This pilot study examined the knowledge, access and intent of the practice-oriented service model of caregivers of persons with dementia in rural communities in the Midwest U.S. After a systematic training, researchers interviewed 11 rural caregivers of persons with dementia (n = 11). Data were analyzed using thematic analysis. Although similarities with other caregivers of persons with dementia were found, important differences suggesting unique issues among these rural caregivers of persons with dementia. Many participants found strength in their community, which often served as a safety net of support. Consistent with existing literature, participants expressed financial concerns, geographic barriers and lack of dementia-specific services when using formal services. The need for more specialized formal services in rural areas to supplement existing informal care networks is discussed. Policies and services based on rural caregivers’ unique concerns and challenges and that build upon their existing care networks are recommended.

Language-Enriched Exercise plus Socialization for Older Adults with Dementia: Translation to Rural Communities

Interventions that stimulate and engage individuals with dementia physically, cognitively, and socially offer promise for improving health and well-being and for potentially slowing functional losses with disease progression. We describe a volunteer-based intervention that combines physical exercise, cognitive-linguistic stimulation, and social outings for older persons living with dementia in rural communities. One-year follow-up data, although clearly preliminary (n = 8), suggest stability in global cognition, mood, and aspects of physical fitness. Challenges to implementing dementia interventions in rural areas are discussed.

Living with dementia in rural and remote Scotland: Diverse experiences of people with dementia and their carers

There is a lack of research into people's experiences of using services as dementia sufferers themselves, or because they care for someone with dementia, in rural areas. This article explores their experiences in the context of rural Scotland, drawing on data gathered from both people with dementia and their carers. Our research suggests that understanding the nuanced and co-constituted experience of dementia in rural communities is a pre-requisite for improving service provision. The paper explores the way in which participants linked their experiences to their spatial location in rural areas. Our findings suggest that participants used a narrative of idealised rurality which linked together interwoven and overlapping social networks, a physical relationship with place and a sense of self sufficiency. However, the participants’ stories also highlighted the diversity in experiences as service users between places, suggesting a disjunction between the generalising narrative of the rural idyll and their particular situations. These findings extend the literature on rural mental health issues and on the experience of dementia in particular, in turn helping to inform place and person centred policies.