A new statewide spatial analysis of Alzheimer's disease and related dementias (ADRD) has revealed major differences in how the condition affects people living in rural parts of Maryland. The findings highlight how access to healthcare can strongly influence health outcomes, offering a clear example of challenges that many rural communities across the United States face.
More than 90% of large hospitals are located in urban areas. That leaves rural hospitals operating with fewer resources and extremely tight financial margins. According to Saeed Namadi from the University of Maryland, one of the most serious obstacles is the lack of doctors, nurses, and specialists trained in Alzheimer's and dementia care, most of whom work in major cities. Because of this imbalance, rural patients often have to travel much farther to receive medical attention. Many of these patients are over 80 years old, making long trips for care especially difficult.
Where You Live Can Affect Alzheimer's Diagnosis
Alzheimer's disease currently affects more than 6.9 million Americans. The Alzheimer's Association estimates that the number of cases could double by 2060. The new research suggests that location can play a major role in whether someone receives a timely diagnosis and proper treatment or whether their condition goes undetected.
Researchers examined data from 422,735 patients in Maryland in 2019. Their analysis indicates that many ADRD cases may be going unrecognized in underserved rural regions. This appears especially true in eastern and western Maryland, where researchers found an unusual pattern of high mortality rates combined with low diagnosis rates. These findings come at a time when healthcare systems continue to face funding pressures that can have serious consequences for older adults and underserved populations.
Study Highlights Factors Driving Alzheimer's Patterns
The study also explored how several factors influence ADRD patterns. Researchers looked at hospital access, demographic characteristics, and related health conditions such as diabetes. The results provide evidence that could help guide targeted policies and programs in clinics, hospitals, and community outreach efforts. While the research focuses on Maryland, the insights may apply to rural communities across the country.
Key Findings
- Underserved regions in eastern and western Maryland show high ADRD mortality rates despite low diagnosis rates, suggesting that many cases remain undiagnosed.
- Hospital accessibility is unevenly distributed, with urban areas having significantly better access than rural areas, where mortality rates are elevated.
- Spatial regression analysis (Getis-Ord G* and GWR models) revealed that lower hospital accessibility is associated with higher poverty rates and higher health risk rates, including diabetes and heart disease.
- Regional variations in these relationships were confirmed through spatial analysis, demonstrating that localized factors significantly influence ADRD outcomes.
