Dementia is more common in those living in rural areas than in senior citizens who live in suburbs and cities, according to a new study.
Researchers found that Americans who live in urban areas tend to be healthier than people living in rural settings due to better access to healthcare.
But they also found that higher levels of education has helped to slow the decline of brain functions among those aged 55 and older in rural communities.
While the disparity has been investigated for more than a decade, researchers have conducted the first nationally representative study to find that dementia and cognitive impairment have consistently been more prevalent among rural dwelling seniors and stressed a need for healthcare equality.
Senior citizens who live in rural areas are more likely have dementia than those who live in cities due to a lack of access to good healthcare, according to the RAND Corporation
The research from the RAND Corporation, a non-profit research organization from California, evaluated more than 16,000 American adults aged 55 or older in 2000 and in 2010 for the study.
Cognitive function was assessed and a score of 12 or more was considered normal cognitive function.
The participants were classified as urban, rural, mixed urban and mixed rural.
Individual characteristics were measured, including age, gender, race, ethnicity, total number of children, marital status, highest educational attainment and net total assets in 2000.
Health conditions including high blood pressure, cancer, diabetes, lung cancer, heart disease, stroke, or psychiatric conditions were taken into account.
Figures from 2000 show that dementia was more prevalent in rural areas (7.1 percent) compared to urban areas (5.4 percent).
But 10 years later there were no significant differences in the rates, with a greater decrease in rural than urban areas.
During the same period, racial and ethnic minorities had made up an even larger portion of urban dwellers in 2010.
Once these and other changes were accounted for the, the fully adjusted relative risk ratio (RRR) of dementia was 60 percent higher in rural areas compared to urban areas in 2000.
In 2010, similarly high rural-urban differences were found.
The rates of dementia and CIND (cognitive impairment no dementia) were about 80 percent and 40 percent higher in rural areas compared to urban areas, according to the findings published in the American Journal of Preventive Medicine.
‘Rural communities are ageing more rapidly than urban communities,’ said senior investigator Dr Regina Shih. ‘Given that those communities experience more healthcare and long-term care system challenges, we hope this research sheds light on the need to intervene on the factors that place rural seniors at greater risk for dementia.’
The proportion of older adults with less than 12 years of education dropped by about half in rural areas between 2000 and 2010.
Researchers suggests that brain health of older people living in rural areas has benefited from rapid increases in high school graduation rates in those communities.
The increase was due to large investments put toward American colleges and universities in the 20th century.
Though those living in rural areas are still behind their urban counterparts, the growth in education has been found to minimize brain deterioration.
Lead investigator Dr Margaret Weden, said: ‘Our findings linking rural adults’ recent gains in cognitive functioning with the improved rates of high school graduation provides a new example of how public investment in education can narrow population health disparities.’
In the US there are believed to be at least five million people suffering age-related dementia.
In a state with many rural areas such as Louisiana, there are at least 100,000 individuals with age-related dementia.
Dementia is categorized as deterioration in cognitive function beyond what might be expected from normal ageing.
The condition affects memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement.
The most common form of the disease is Alzheimer’s, affecting about six million Americans.
Dr Regina Shih said: ‘The incidence of dementia is expected to double by 2050 largely because of the ageing cohort of Baby Boomers.
‘While many studies to date have focused on individual-level sources of disparity – for example, racial and ethnic origins – this is the first study to report a rural-urban differential that behooves the scientific and clinical community to address the attendant factors that confer higher risk for dementia in rural seniors,’ said Dr Shih.
She added, ‘We were heartened to observe that the rural-urban disparities in dementia have narrowed somewhat over time, however there is still a disadvantage that persists among rural seniors.