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Early-Onset Alzheimer Disease Patients in Rural Areas Lack Specialty Care

Rural patients more likely to be diagnosed and treated by primary care providers

TUESDAY, Aug. 9, 2022 (HealthDay News) — Patients with early-onset Alzheimer disease and related dementias (ADRDs) living in rural areas have fewer neuropsychological tests and visits to clinical psychologists than patients living in urban areas, according to a study published online Aug. 5 in JAMA Network Open.

Wendy Y. Xu, Ph.D., from The Ohio State University in Columbus, and colleagues examined rural versus urban differences in diagnostic and symptom management service use among patients with early-onset ADRDs (ages 40 to 64 years). The analysis included commercial claims (2012 to 2017) for 71,799 patients with early-onset ADRDs.

The researchers observed no statistically significant differences between new patients with early-onset ADRDs in rural versus urban areas for the use of psychological assessments, imaging studies, or visits to neurologists or psychiatrists. However, new patients in rural areas were less likely to receive neuropsychological testing (odds ratio, 0.83) or visit a psychologist (odds ratio, 0.72) versus patients in urban areas. New early-onset ADRD patients in rural areas were more likely to have only primary care provider visits for diagnosis and symptom management compared with patients in urban areas (odds ratio, 1.40).

“Specialty care, including neuropsychological assessments, [is] pretty critical for people with dementia to get an accurate diagnosis and set a symptom management plan,” Xu said in a statement. “These are advanced, complex tests that most primary care physicians are not trained to perform.”

One author disclosed financial ties to Aveanna Healthcare.

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