Social Determinants of Health among Older Adults with Dementia in Urban and Rural Areas

• Published in: The journal of prevention of Alzheimer's disease 2023-08, Vol.10 (4), p.895-902
• Main Authors: Bartley, Mairead M., Baer-Benson, H., Schroeder, D. R., St. Sauver, J. L., Khera, N., Griffin, J. M.
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Medicine; Medicine & Public Health; Neurology; Original Research
• ISSN: 2426-0266; 2426-0266
• DOI: 10.1007/s42414-023-0002-2

Background Social determinants of health (SDOH) may influence health in people living with dementia. Little is known about SDOH differences in urban compared to rural dwelling people living with dementia. Objectives To explore urban-rural differences in SDOH in people living with mild cognitive impairment (MCI) and dementia. Design Descriptive study. Setting /Participants People ≥55 years with MCI or dementia empaneled to Community Internal Medicine at Mayo Clinic (Rochester, MN, USA) who completed SDOH questions between June 1, 2019 and June 30, 2021 were included. Measurements SDOH questions addressed education, depression, alcohol use, financial strain, food insecurity, physical activity, social connections, stress and transportation. SDOH data were compared by location based on Rural-Urban Commuting Areas Codes. Results Of 3552 persons with MCI (n=1495) or dementia (n=2057), 62% lived in urban areas, 19% in large rural, 10% in small rural and 9% in isolated areas. Approximately 60% were physically inactive, 20% socially isolated and 30% had stress concerns. Rural patients experienced greater financial strain (p=0.003). Conclusion Social isolation, stress and physical inactivity are common in people living with MCI and dementia across urban and rural areas. Targeted interventions to improve physical and psychosocial health could have great impact in this population.