Although more than 20% of the US population live in rural areas, this is an underserved and understudied population. Rural adults suffer disproportionately poorer health and worse health outcomes compared with the rest of the nation. Considerably less research has focused on cognitive health outcomes and their risk factors among older, rural dwelling adults. Among these cognitive changes is mild cognitive impairment (MCI), a condition that affects as many as 19% of older US adults and is widely recognized as a risk state for Alzheimer's Disease and other dementias. As such, MCI represents a key target for interventions aimed at the secondary prevention of dementia. We have reason to believe that older, rural adults are especially vulnerable to MCI, based on known higher rates of factors associated with the syndrome. Complicating matters, limited resources and access to care may lead to delayed detection of cognitive changes, making rural adults an especially vulnerable group that is possibly deprived of opportunities for screening and early intervention in the disease process. Based on known rural health disparities, especially later diagnosis of chronic diseases, it is reasonable to hypothesize that MCI may present later in its course in rural adults, but studies describing older, rural dwelling adults with MCI are absent from the literature. The primary purpose of this study is to determine if rural residence is a unique risk factor for delayed detection of MCI. This novel study will examine MCI symptom severity and qualitative description to gain insight into rural cognitive health. The study seeks t advance the science by improving the understanding of MCI in a vulnerable population, which may ultimately direct the development of future health promotion research.

Public Health Relevance

Poorer health outcomes in older, rural dwelling adults continue to be addressed in the literature, but one condition that is rapidly increasing among older adults, and yet has not been examined in this vulnerable population, is mild cognitive impairment. Mild cognitive impairment is a condition that is widely recognized as a risk state for Alzheimer's Disease and other dementias, and therefore, represents a key target for interventions aimed at the secondary prevention of dementia. The proposed research aims to describe cognitive decline in older rural dwelling adults to ultimately inform the development of future interventions or programs to slow disease progression and subsequently reduce dementia incidence in this vulnerable population.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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Nursing Science Review Committee (NRRC)
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Banks, David
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University of Pittsburgh
Schools of Nursing
United States
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Mattos, Meghan K; Nilsen, Marci L; Lingler, Jennifer H (2018) Experiences Surrounding an Early-Stage Cognitive Diagnosis in Rural-Dwelling Older Adults. Res Gerontol Nurs 11:181-189
Mattos, Meghan K; Snitz, Beth E; Lingler, Jennifer H et al. (2017) Older Rural- and Urban-Dwelling Appalachian Adults With Mild Cognitive Impairment. J Rural Health 33:208-216
Mattos, Meghan K; Burke, Lora E; Baernholdt, Marianne et al. (2017) Perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment. Dementia (London) :1471301217694250