December 13, 2017
Studies have shown that people who live in urban areas tend to be healthier than those who live in rural areas. This is largely attributed to greater access to health care and education, two factors that have been linked to longer life spans. Researchers at RAND Corporation in Santa Monica, Calif. have zeroed in on the disparity between city and country dwellers, and found that dementia and cognitive impairment appear more often in rural areas than they do in urban areas. Scientists also found that while rural seniors seem to have a higher risk of dementia, they have also greatly benefited from a push in rural communities to increase high school graduation rates.
Researchers at the RAND Corporation in Santa Monica, Calif. looked at a sample of 16,000 adults over the age of 55—once in 2000 and once in 2010. They were evaluated by phone interview and given a score based on their answers, then classified as having either dementia, cognitive impairment or normal cognitive function. Researchers also asked about age, gender, race, ethnicity, total number of children, marital status, highest educational attainment, and net total assets in 2000, along with health conditions like high blood pressure, cancer, diabetes, lung cancer, heart disease, stroke or psychiatric conditions.
Scientists concluded that the relative risk was 60% higher for dementia and 44% higher for cognitive impairment in rural areas compared to urban areas in 2000, and 80% higher for dementia and 40% higher for cognitive impairment in rural compared to urban areas in 2010. Relative risk is the percentage change in one’s absolute risk as a result of some change in behavior—in this case, it was living in a rural area rather than an urban area. That doesn’t mean those who live in rural areas have a 60 to 80 percent chance of getting dementia; it means that they were 60 and 80 percent more likely to get dementia than their urban counterparts.
“Rural communities are aging more rapidly than urban communities. Given that those communities experience more health care 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,” said senior investigator Regina Shih, Ph.D.
Researchers found that the most protective factor against dementia was not wealth or even age. Education, said the researchers, seemed to be the most decisive factor. For those with 12 or more years of education, the relative risk was 83% and 89% lower.
In fact, there was a decrease in the incidence of dementia between 2000 and 2010 in rural areas, which researchers attribute to increased high school graduation rates in rural areas.
“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,” said lead investigator Margaret M. Weden, Ph.D.
The study was published in American Journal of Preventative Medicine.