Mairead M. Bartley, M.B., B.Ch., B.A.O., M.D., Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Phone 507-284-5278, E-mail:
J Prev Alzheimers Dis. 2023;10(4):895-902. doi: 10.1007/s42414-023-0002-2.
Social determinants of health (SDOH) may influence health in people living with dementia. Little is known about SDOH differences in urban compared to rural dwelling people living with dementia.
To explore urban-rural differences in SDOH in people living with mild cognitive impairment (MCI) and dementia.
Descriptive study.
SETTING/PARTICIPANTS: People ≥55 years with MCI or dementia empaneled to Community Internal Medicine at Mayo Clinic (Rochester, MN, USA) who completed SDOH questions between June 1, 2019 and June 30, 2021 were included.
SDOH questions addressed education, depression, alcohol use, financial strain, food insecurity, physical activity, social connections, stress and transportation. SDOH data were compared by location based on Rural-Urban Commuting Areas Codes.
Of 3552 persons with MCI (n=1495) or dementia (n=2057), 62% lived in urban areas, 19% in large rural, 10% in small rural and 9% in isolated areas. Approximately 60% were physically inactive, 20% socially isolated and 30% had stress concerns. Rural patients experienced greater financial strain (p=0.003).
Social isolation, stress and physical inactivity are common in people living with MCI and dementia across urban and rural areas. Targeted interventions to improve physical and psychosocial health could have great impact in this population.
健康的社会决定因素（SDOH）可能会影响痴呆患者的健康。对于居住在城市和农村的痴呆患者的 SDOH 差异，人们知之甚少。
探索居住在城市和农村的轻度认知障碍（MCI）和痴呆患者的 SDOH 差异。
描述性研究。
地点/参与者：2019 年 6 月 1 日至 2021 年 6 月 30 日期间，在 Mayo Clinic（明尼苏达州罗切斯特市）社区内科登记的≥55 岁 MCI 或痴呆患者，他们完成了 SDOH 问题。
SDOH 问题涉及教育、抑郁、饮酒、经济压力、食物不安全、身体活动、社会联系、压力和交通。根据农村-城市通勤区代码，按地点比较 SDOH 数据。
在 3552 名 MCI（n=1495）或痴呆（n=2057）患者中，62%居住在城市地区，19%居住在大农村地区，10%居住在小农村地区，9%居住在偏远地区。大约 60%的人身体不活跃，20%的人社会孤立，30%的人有压力问题。农村患者经济压力更大（p=0.003）。
在城市和农村地区，MCI 和痴呆患者普遍存在社会隔离、压力和身体不活动。针对改善身体和心理健康的针对性干预措施可能会对这一人群产生重大影响。
