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Rural Health Information Hub
Rural Health Information Hub

Alzheimer’s Disease and Related Disorders Models for Rural Healthy Aging

Alzheimer's disease and related disorders (ADRD) refer to the most common forms of dementia — the loss of the ability to think, remember, reason, and carry out daily activities. Alzheimer's is the most common cause of dementia among older adults. Alzheimer's disease and related disorders disproportionately affect older adults in rural areas. In addition, people with dementia who reside in rural areas have higher mortality rates and less access to healthcare services compared to urban persons with dementia.

Depending on the severity of their dementia, people may need healthcare, medications, and around-the-clock care to manage their symptoms. Often, family members or friends become caregivers for adults with Alzheimer's disease and related disorders. Caregiving can be rewarding but is also hard and may increase caregivers' stress and risk of depression, as well as negatively impacting their health. For these reasons, it is essential for caregivers to take care of themselves while they care for others. A directory of evidence-based caregiver support programs is available to help caregivers of people with ADRD.

There is currently no cure for Alzheimer's, although several Food and Drug Administration-approved medications can help people manage their symptoms. Screening for Alzheimer's disease and related disorders is vital to detect issues early because medications tend to work best for people in the early or middle stages of Alzheimer's.

The causes of Alzheimer's and related disorders are not well understood; however, a combination of age-related changes in the brain, genetics, health, environmental, and lifestyle factors may play a role. Leading a healthy lifestyle, such as maintaining a healthy weight, keeping physically active, and eating a healthy diet may help prevent Alzheimer's and related disorders.

Community programs can address Alzheimer's disease and related disorders by focusing on risk reduction, early detection, and prevention of comorbidities.

  • The Healthy Brain Initiative's Road Map for American Indian and Alaska Native Peoples offers public health strategies to consider as part of a broad response to dementia. The road map also highlights examples of tribal leaders and community partners leveraging local strengths and resources within their tribal communities to address dementia.
  • Improving Mood — Promoting Access to Collaborative Treatment (IMPACT) Model is designed for adults with diagnosis of major depression or dysthymia, often in conjunction with another major health problem. As part of this collaborative model, a trained depression care manager works with the patient, the patient's primary care provider, and a psychiatrist to develop and administer a course of treatment.
  • Building Our Largest Dementia (BOLD) Infrastructure Public Health Program is funded by the Centers for Disease Control and Prevention to reduce the risk of dementia, increase early detection and diagnosis, prevent avoidable hospitalizations, and support dementia caregiving. Supported by BOLD, the Mississippi Alzheimer's Disease and Related Dementias Program (MS ADRDP) uses an evidence-based, data-driven approach to enhance and implement a statewide ADRD strategic plan, develop a public health education program, and enhance partnerships to reduce ADRD morbidity and mortality. Ambassadors, who are typically older adults with public health experience, serve on committees and amplify the voices of older adults. Read more about BOLD in Module 3.

Considerations for Implementation

When selecting or recruiting for mental health and well-being programs, implementers should ensure people are matched with services that meet their needs. Further, some programs may require a specific diagnosis or level of severity for an older adult to qualify for participation (for example, major depression, late-stage dementia).

Consider integrating ADRD models into programs that address frequently co-occurring chronic conditions, such as heart disease and diabetes, or programs that address risk factors for developing dementia, such as programs for individuals with traumatic brain injury.

Community members, partners, providers, and staff implementing ADRD models may benefit from education on how to effectively communicate and problem-solve with people with ADRD. Models that require highly specialized staff or complex coordination may be better suited for larger organizations or well-resourced communities. Smaller communities may find success sharing resources with other local communities.

Partnerships are important for creating meaningful systems change that result in more age-friendly communities to support people with ADRD. Partnering with recognized and trusted institutions like churches and libraries can help older adults overcome the stigma of seeking help for ADRD-related issues.

Partners that do not serve older adults or those with ADRD can still make valuable contributions to creating age-friendly communities. Making the case that ADRD risk factors (physical inactivity, obesity, unmanaged diabetes, smoking) impact community members beyond only those diagnosed with ADRD can create buy-in and shared goals with partners. Additionally, using terms like "brain health" can resonate with community members and partners more broadly and promote a more holistic understanding of ADRD that goes beyond a clinical diagnosis.

Engaging older adults with ADRD as advisors in the co-design of the programs helps to ensure that the program includes things that are important to older adults with ADRD. Incorporating the views of older adults with ADRD can encourage older adults' participation and contribute to achieving positive results.

Resources to Learn More

Best Programs for Caregiving
Directory
Searchable directory for family caregivers, program providers, and organizations to learn about evidence-based dementia support programs in their area.
Organization(s): Benjamin Rose Institute on Aging, Family Caregiver Alliance

Memory Impairment and Neurodegenerative Dementia (MIND) Center Resources
Website
Provides links to information on dementia, including reports, studies, and examples of a state's strategic plan.
Organization(s): The University of Mississippi Medical Center

The Most Costly Chronic Medical Condition in America: Experts Talk About the Rural Aspects of Alzheimer's Disease and Related Dementias
Document
Rural healthcare providers and experts discuss considerations for providing care for Alzheimer's disease and related conditions in rural areas, including summarizing recent data, models for rural communities, and federal resources.
Author(s): Miller Temple, K.
Organization(s): Rural Health Information Hub
Citation: Rural Monitor
Date: 6/2020

Support for People with Dementia, including Alzheimer's Disease
Website
Discusses strategies to support older adults with ADRD and their caregivers. Provides information on supportive services, programs, and grants.
Organization(s): Administration on Community Living

Tips for Caregivers and Families of People with Dementia
Website
Discusses how caregivers and families can best support loved ones with dementia, such as how to navigate daily activities, communication and behavior, healthy lifestyles, and home safety.
Organization(s): Alzheimers.gov