Rural Adults Show Higher Dementia Risk Burden
Rural Americans aged 45 years and older face a significantly higher prevalence of modifiable dementia risk factors than their urban counterparts, according to recent national data.
Rural-Urban Gaps in Modifiable Dementia Risk Factors
This cross-sectional study examined data from 16,981 adults participating in the 2023 National Health Interview Survey. Researchers evaluated 11 modifiable dementia risk factors including hypertension, high cholesterol, diabetes, obesity, hearing loss, visual impairment, depression, and smoking, along with seven corresponding treatments.
The analysis found that rural residents were more likely to have hypertension (adjusted rate ratio [aRR] 1.11; 95% CI, 1.06–1.17), obesity (aRR 1.22; 95% CI, 1.15–1.30), diabetes (aRR 1.29; 95% CI, 1.15–1.45), and hearing loss (aRR 1.22; 95% CI, 1.12–1.34) compared with urban residents. Disparities were most pronounced among middle-aged adults (45–64 years) and in the South and Midwest regions, where social and structural determinants may compound health inequities.
Treatment Rates and Public Health Implications
While treatment for cardiometabolic conditions such as hypertension, high cholesterol, and diabetes exceeded 85% across all regions, care for sensory and behavioral risk factors including hearing loss and depression lagged behind. The findings highlight persistent gaps in prevention and management that could accelerate dementia risk among some vulnerable populations.
Addressing Structural Inequities
The study emphasizes the need for targeted public health interventions focused on rural populations, including improved access to preventive care, behavioral health services, and sensory screening. By addressing modifiable dementia risk factors early, clinicians and policymakers can play a pivotal role in reducing the long-term burden of Alzheimer’s disease and related dementias across the United States.
Targeted prevention programs, improved access to behavioral and sensory care, and community-based education could help mitigate these risks and reduce the growing dementia burden across rural U.S. populations.
Reference: Xie Z et al. Rural-urban differences in modifiable dementia risk factors among U.S. populations aged 45 years or older. J Alzheimers Dis Rep. 2025;9:25424823251395318.
