4.5 Article

Detecting dementia among older, ethnically diverse residents of rural subsidized housing

Journal

GERIATRIC NURSING
Volume 42, Issue 2, Pages 524-532

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.gerinurse.2020.09.005

Keywords

Rural; Ethnically diverse older adults; Dementia detection; AGNP; Subsidized Housing

Funding

  1. Florida Department of Health, Ed and Ethel Moore Alzheimer's Disease Research Program [7AZ28]
  2. National Institutes of Health [R01 AG040211-A1, R01 NS101483-01A1]
  3. Institutional Review Board of Florida Atlantic University [719852-6]

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Rural, ethnically diverse residents have a higher risk of Alzheimer's disease compared to urban residents, partly due to the prevalence of chronic diseases and lack of access to specialty providers in rural areas. A home-based approach for dementia management among rural residents has shown promising results in increasing detection and treatment rates, ultimately reducing costly institutionalizations.
Rural, ethnically diverse residents face at least twice the risk of Alzheimer's disease than urban residents. Chronic diseases such as diabetes and hypertension which increase dementia risk are more prevalent in rural areas with less access to specialty providers. A home-based approach for increasing dementia detection and treatment rates was tested among rural residents of government-assisted independent living facilities (N = 139; 78% non-White, and 70% with health literacy below 5th grade). Of 28 residents identified at risk during cognitive screening, 25 agreed to further in-depth assessment by adult gerontological nurse practitioners (AGNP). Fifteen of 25 (60%) completing consequent primary provider referrals were diagnosed with dementia and receiving new care (statistically significant; [chi(2)(1) = 76.67, p < .001, Phi = 0.743]). Home-based dementia management through a community engagement approach can help to meet the Healthy People 2030 goals of earlier detection and treatment and reduce the length of costly institutionalizations. (C) 2020 Elsevier Inc. All rights reserved.

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