Urban-rural differences in a memory disorders clinical population.
OBJECTIVE
To compare patient characteristics and family perceptions of patient function at one urban and one rural memory disorders clinic.


METHODS
Secondary, cross-sectional data analyses of an extant clinical database.


METHODS
First time visits (n = 956) at two memory disorders clinics.


METHODS
Patient and family-member demographics and assessment results for the Mini-Mental State Examination (MMSE), instrumental activities of daily living (IADLs), activities of daily living (ADLs), the Memory Change and Personality Change components of the Blessed Dementia Rating Scale, and the Revised Memory and Behavior Problems Checklist.


RESULTS
In both clinics, patients and family members were more likely female. The typical urban clinic patient was significantly more likely to be living in a facility and more educated than the typical rural patient. Urban and rural patients did not show significant differences in age- and education-adjusted MMSE scores or raw ADL/IADL ratings, but the urban family members reported more memory problems, twice as many personality changes, more-frequent behavior problems, and more adverse reactions to problems.


CONCLUSIONS
Physicians who practice in both urban and rural areas can anticipate differences between patients, and their families, who seek a diagnosis of memory disorders. Our most important finding is that despite similarities in reported functional abilities, urban families appear to be more sensitive to and more distressed by patients' cognitive and behavioral symptoms than rural families. These differences may reflect different underlying needs, and should be explored in further research.
Wackerbarth
S B
SB
Martin School of Public Policy and Administration, University of Kentucky, Lexington 40506, USA.
Johnson
M M
MM
Markesbery
W R
WR
Smith
C D
CD
D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000554:Ambulatory Care Facilities; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004522:Educational Status; D005190:Family / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D008609:Mental Status Schedule; D010551:Personality; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D017678:Sex Distribution; D017062:Small-Area Analysis; D014504:Urban Health / Q000706:statistics & numerical data*