Mild Cognitive Impairment in Older Rural Dwelling Adults

描述（由申请人提供）：尽管超过20%的美国人口生活在农村地区，但这是一个未得到充分服务和研究的人口。与全国其他地区相比，农村成年人的健康状况更差，健康结果也更差。很少有研究关注农村老年人的认知健康结果及其风险因素。在这些认知变化中包括轻度认知障碍（MCI），这种疾病影响多达19%的美国老年人，被广泛认为是阿尔茨海默病和其他痴呆症的风险状态。因此，轻度认知障碍是旨在二级预防痴呆症的干预措施的一个关键目标。我们有理由相信，年龄较大的农村成年人特别容易患轻度认知障碍，因为已知与该综合征相关的因素发病率较高。使问题更加复杂的是，有限的资源和获得护理的机会可能导致认知变化的检测延迟，使农村成年人成为一个特别脆弱的群体，可能被剥夺了在疾病过程中进行筛查和早期干预的机会。基于已知的农村健康差异，特别是慢性病的晚期诊断，有理由假设农村成年人的轻度认知损伤可能在病程的后期出现，但文献中缺乏描述老年农村居民患有轻度认知损伤的研究。本研究的主要目的是确定农村居住是否是延迟发现MCI的唯一危险因素。本研究将检验MCI症状严重程度和定性描述，以深入了解农村认知健康状况。这项研究旨在通过提高对弱势群体中轻度认知障碍的理解来推进科学，这可能最终指导未来健康促进研究的发展。

DESCRIPTION (provided by applicant): 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.