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Rural residence across the life course and late‐life cognitive decline in KHANDLE: A causal inference study

Rural residence across the life course and late‐life cognitive decline in KHANDLE: A causal... INTRODUCTIONRural health disparities have been documented for many behaviors and conditions attributed to population risk of dementia.1–3 Rural health disparities may arise due to persistent structural urbanism: the allocation of health care and public health–promoting resources that favors population centers, at the expense of rural communities.4 Inequities arise from population‐level programs that aim to impact large numbers and avoid the inefficiency of reaching more remote communities, which may limit cognition‐promoting public goods (e.g., public libraries) in rural areas. At the same time, market‐driven private resources, such as health‐care systems and knowledge sectors employment opportunities, favor urbanized communities with a greater concentration of residents with higher socioeconomic status (SES). Structural urbanism theory thus suggests rural residence may impact dementia risk both through and independently of individual SES. Furthermore, life‐course theory suggests the timing and duration of rural residence may also be important. The sensitive period model suggests that childhood, adolescence, and early adulthood are critical periods for cognitive development, and that exposures during these periods have a profound impact on later life cognitive outcomes.5RESEARCH IN CONTEXTSystematic Review: Relevant scientific studies were reviewed on PubMed. Few studies have examined the relationship between rural residence and cognitive aging outcomes. Available studies suggest http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring Wiley

Rural residence across the life course and late‐life cognitive decline in KHANDLE: A causal inference study

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References (35)

Publisher
Wiley
Copyright
© 2023 the Alzheimer's Association.
eISSN
2352-8729
DOI
10.1002/dad2.12399
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONRural health disparities have been documented for many behaviors and conditions attributed to population risk of dementia.1–3 Rural health disparities may arise due to persistent structural urbanism: the allocation of health care and public health–promoting resources that favors population centers, at the expense of rural communities.4 Inequities arise from population‐level programs that aim to impact large numbers and avoid the inefficiency of reaching more remote communities, which may limit cognition‐promoting public goods (e.g., public libraries) in rural areas. At the same time, market‐driven private resources, such as health‐care systems and knowledge sectors employment opportunities, favor urbanized communities with a greater concentration of residents with higher socioeconomic status (SES). Structural urbanism theory thus suggests rural residence may impact dementia risk both through and independently of individual SES. Furthermore, life‐course theory suggests the timing and duration of rural residence may also be important. The sensitive period model suggests that childhood, adolescence, and early adulthood are critical periods for cognitive development, and that exposures during these periods have a profound impact on later life cognitive outcomes.5RESEARCH IN CONTEXTSystematic Review: Relevant scientific studies were reviewed on PubMed. Few studies have examined the relationship between rural residence and cognitive aging outcomes. Available studies suggest

Journal

Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring – Wiley

Published: Jan 1, 2023

Keywords: cognitive aging; cohort study; epidemiology; health disparities

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