Rural-Urban Differences in Chronic Disease and Drug Utilization in Older Oregonians.

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• The health status and healthcare needs of the oldest old (≥85 years) are critical public health concerns.
• Understanding geographical differences in disease burden and medication use is essential for targeted interventions.

Purpose of the Study:

• To compare disease burden and medication usage between rural and urban community-dwelling adults aged 85 years and older.
• To characterize health disparities in the oldest-old population based on geographic location.

Main Methods:

• Secondary analysis of longitudinal data from three brain-aging studies (KEAP, OBAS, DPS) initiated around 2000.
• Inclusion criteria: age ≥85 years, at least two follow-up visits.
• Disease burden assessed using Modified Cumulative Illness Rating Scale (MCIRS); medication usage quantified by mean number of medications.

Main Results:

• Rural participants exhibited significantly higher baseline disease burden (MCIRS 23.0 vs. 21.0) compared to urban participants.
• The rural population showed a higher rate of disease accumulation (0.2 MCIRS increase/year).
• Rural older adults used more medications on average (5.5 vs. 3.7) than their urban counterparts (P < .0001).

Conclusions:

• Significant differences exist in disease burden and medication use between rural and urban Oregonians aged ≥85 years.
• Findings suggest potential healthcare disparities for older adults in rural settings.
• Further research is needed to identify strategies for improving healthcare access and outcomes for this demographic.