A new statewide spatial analysis of Alzheimer’s disease and related dementias (ADRD) reveals significant differences in how the condition affects people living in rural Maryland. The findings highlight how access to health care can significantly impact health outcomes and provide a clear example of the challenges facing many rural communities across the United States.
More than 90% of large hospitals are located in urban areas. As a result, rural hospitals operate with reduced resources and very tight financial margins. One of the most serious obstacles is the lack of doctors, nurses and specialists trained to treat Alzheimer’s disease and dementia, most of whom work in large cities, said Saeed Namadi of the University of Maryland. Because of this disparity, patients in rural areas often have to travel further to receive medical care. Many of these patients are over 80 years old, making long-term travel for treatment particularly difficult.
Where you live may affect your Alzheimer’s diagnosis
Currently, more than 6.9 million Americans have Alzheimer’s disease. The Alzheimer’s Association estimates that the number of cases could double by 2060. New research suggests location may play a big role in whether people receive timely diagnosis and appropriate treatment, or if the condition goes undetected.
Researchers looked at data from 422,735 patients in Maryland in 2019. Their analysis indicates that many ADRD cases may go unrecognized in underserved rural areas. This appears to be especially true in eastern and western Maryland, where researchers found an unusual pattern of high death rates combined with low diagnosis rates. These findings were announced as health systems continue to face funding pressures that can severely impact older adults and underserved populations.
Research reveals factors that drive Alzheimer’s disease patterns
This study also investigated how several factors influence ADRD patterns. Researchers looked at access to hospitals, demographic characteristics, and related health conditions such as diabetes. The results provide evidence that can guide targeted policies and programs in clinics, hospitals, and community outreach efforts. Although this study focuses on Maryland, the insights may apply to rural areas across the country.
Main findings
- Despite low diagnosis rates, underserved areas of eastern and western Maryland have high mortality rates from ADRD, suggesting that many cases remain undiagnosed.
- Access to hospitals is unevenly distributed, with urban areas having significantly better access than rural areas, where mortality rates are higher.
- Spatial regression analyzes (Getis-Ord G* and GWR models) revealed that lower access to hospitals was associated with higher rates of poverty and health risks such as diabetes and heart disease.
- Regional variations in these relationships were confirmed by spatial analysis, demonstrating that local factors significantly influence ADRD outcomes.
