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Related Concept Videos

Dementia01:30

Dementia

108
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
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Alzheimer's Disease: Overview01:26

Alzheimer's Disease: Overview

456
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
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Rural-Urban mild cognitive impairment comparison in West Michigan through EHR.

Xiaodan Zhang1, Martin Witteveen-Lane2, Christine Skovira1,2

  • 1Department of Pediatrics and Human Development Michigan State University Grand Rapids Michigan USA.

Alzheimer'S & Dementia (New York, N. Y.)
|August 13, 2024
PubMed
Summary

Mild cognitive impairment (MCI) is underdiagnosed in rural areas, with urban patients showing higher incidence and access to neurological care. Risk factors vary, but common ones include diabetes and stroke.

Keywords:
dementiaelectronic health recordshealth disparityincidence ratesmild cognitive impairmentrisk factorsurbanization

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Area of Science:

  • Neurology
  • Public Health
  • Geriatrics

Background:

  • Mild cognitive impairment (MCI) is a critical public health issue and a potential precursor to Alzheimer's disease (AD).
  • Electronic health records (EHRs) offer valuable insights into population health trends, including geographic disparities in disease incidence and care access.

Purpose of the Study:

  • To investigate rural-urban differences in MCI incidence, risk factors, and healthcare utilization in West Michigan using EHR data.
  • To identify specific risk factors associated with MCI in urban versus rural populations.
  • To assess disparities in access to neurological care between rural and urban patients.

Main Methods:

  • Analysis of 1,528,464 patient records from Corewell Health West (1/1/2015-7/31/2022).
  • Identification of MCI cases (aged 45+) using ICD codes, excluding prior dementia/AD diagnoses.
  • Examination of incidence rates, risk factors (Cox regression), and referral patterns for neurological services across rural and urban settings.

Main Results:

  • Higher MCI incidence in urban areas (3.83/1000 person-years) vs. rural (3.22/1000 person-years), though rural rates increase when including dementia progression.
  • Urban patients had greater access to and completion of neurological referrals.
  • Identified urban-specific MCI risk factors (hearing loss, IBD, sleep apnea, insomnia, African American, underweight) and common factors (diabetes, stroke, age).

Conclusions:

  • Significant rural-urban disparities exist in MCI incidence and access to specialist care, suggesting potential underdiagnosis in rural areas.
  • Reduced access to specialists may contribute to lower observed MCI rates in rural populations.
  • Further research into socioeconomic and environmental factors is needed to tailor MCI prevention and management strategies.