Abstract
•Rural, ethnically diverse residents face at least twice the dementia risk than urban residents.•Home-based cognitive screening and follow-up by AGNPs in rural settings was a successful approach.•Rural providers welcomed AGNP dementia-specific evaluations when discussing patient memory loss.•Hartford institute of geriatric nursing offers resources regarding dementia diagnosis and treatment.•Policy changes supporting AGNP rural home visits for dementia detection can improve health outcomes.
Rural, ethnically diverse residents face at least twice the risk of Alzheimer's disease than urban residents. Chronic diseases such as diabetes and hypertension which increase dementia risk are more prevalent in rural areas with less access to specialty providers. A home-based approach for increasing dementia detection and treatment rates was tested among rural residents of government-assisted independent living facilities (N = 139; 78% non-White, and 70% with health literacy below 5th grade). Of 28 residents identified at risk during cognitive screening, 25 agreed to further in-depth assessment by adult gerontological nurse practitioners (AGNP). Fifteen of 25 (60%) completing consequent primary provider referrals were diagnosed with dementia and receiving new care (statistically significant; [χ2(1) = 76.67, p < .001, Phi = 0.743]). Home-based dementia management through a community engagement approach can help to meet the Healthy People 2030 goals of earlier detection and treatment and reduce the length of costly institutionalizations.
