While research often focuses on the increased risks of Alzheimer’s disease in rural and tribal communities, that is only half the story. These same communities are also leading innovative efforts to support those living with the disease. More than 7 million Americans have Alzheimer’s, a type of dementia that affects memory, thinking and social ability. For Alzheimer’s and Brain Awareness Month in June, University of Minnesota researchers share key lessons learned from their work with these communities.
Tailoring solutions matters
Rural and tribal residents with dementia often face delays in diagnosis, limited access to healthcare and transportation challenges. But a one-size-fits-all solution won’t work. It’s critical to understand communities’ unique needs and strengths, said Carrie Henning-Smith, co-director of the University of Minnesota’s Rural Health Research Center.
“Rural places are not monolithic,” Henning-Smith said. “Rural residents are diverse and their risk factors and experiences with dementia will vary from person to person and place to place.”
Better prevention strategies are possible
Historically, dementia research has focused on more affluent, urban residents, leading to screening tools and prevention strategies that fail to meet the needs of diverse communities. Addressing this requires listening to community members to understand the gaps and identify new solutions, said Cliff Whetung, a social worker and public health researcher at the University of Minnesota Medical School, Duluth Campus.
Whetung is collaborating with Indigenous communities through the Memory Keepers Medical Discovery Team to improve the accuracy of dementia-related data, which benefits not only these communities but future scientific advancement.
“Our goal with this community-engaged approach is to repair those legacies of distrust with rural and indigenous populations created by researchers who have done harm in the past, “ Whetung said. “We’re trying to create a research paradigm organized around collaboration and create better science in the process.”
Technology can boost exercise rates
Physical activity helps prevent dementia, but rural residents often face barriers including a lack of gyms, green space and transportation challenges, said Dereck Salisbury, an associate professor with the University of Minnesota School of Nursing.
Online coaching can help bridge this gap. Salisbury led a pilot study providing rural residents with exercise equipment and a home visit to set up real-time, online exercise classes; attendance rates for the 36-session program for the 10 participants was 85%. He is now seeking funding to expand the pilot.
“It is estimated that half of dementia cases could be prevented or delayed by addressing 14 risk factors. Those six risk factors, obesity, depression, hypertension, diabetes, high cholesterol and physical inactivity, can be improved through regular exercise. Technology and personalized support can help break down those geographic barriers,” Salisbury said.
Rural innovation is redefining dementia care
While small towns face plenty of challenges, a key strength is a powerful sense of community. University of Minnesota researcher Joseph Gaugler has seen this firsthand. He is traveling to all 87 Minnesota counties to learn from residents and share research, and is encouraged by the growing number of communities earning the dementia friendly designation. These visits help ensure his research aligns with community priorities.
“There is significant resilience and innovation in rural communities,” said Gaugler, director of the University of Minnesota’s Center for Healthy Aging and Innovation. “Much of this work is community-led, including ongoing educational sessions, special support groups, and meal distribution to residents in need. These efforts are helping redefine what local support for people with Alzheimer’s can look like.”
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