title: Rural-Urban Differences in Chronic Disease and Drug Utilization in Older Oregonians.
abstract: To characterize disease burden and medication usage in rural and urban adults aged ≥85 years.
  
  
  
  This is a secondary analysis of 5 years of longitudinal data starting in the year 2000 from 3 brain-aging studies. Cohorts consisted of community-dwelling adults: 1 rural cohort, the Klamath Exceptional Aging Project (KEAP), was compared to 2 urban cohorts, the Oregon Brain Aging Study (OBAS) and the Dementia Prevention study (DPS). In this analysis, 121 participants were included from OBAS/DPS and 175 participants were included from KEAP. Eligibility was determined based on age ≥85 years and having at least 2 follow-up visits after the year 2000. Disease burden was measured by the Modified Cumulative Illness Rating Scale (MCIRS), with higher values representing more disease. Medication usage was measured by the estimated mean number of medications used by each cohort.
  
  
  
  Rural participants had significantly higher disease burden as measured by MCIRS, 23.0 (95% CI: 22.3-23.6), than urban participants, 21.0 (95% CI: 20.2-21.7), at baseline. The rate of disease accumulation was a 0.2 increase in MCIRS per year (95% CI: 0.05-0.34) in the rural population. Rural participants used a higher mean number of medications, 5.5 (95% CI: 4.8-6.1), than urban participants, 3.7 (95% CI: 3.1-4.2), at baseline (P < .0001).
  
  
  
  These data suggest that rural and urban Oregonians aged ≥85 years may differ by disease burden and medication usage. Future research should identify opportunities to improve health care for older adults.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland, Oregon.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Goeres
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland, Oregon.
authors.forename: Allison
authors.initials: A
authors.lastname: Gille
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland, Oregon.
authors.forename: Jon P
authors.initials: JP
authors.lastname: Furuno
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, Oregon.
authors.forename: Deniz
authors.initials: D
authors.lastname: Erten-Lyons
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland, Oregon.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Hartung
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, Klamath Falls, Oregon.
authors.forename: James F
authors.initials: JF
authors.lastname: Calvert
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland, Oregon.
authors.forename: Sharia M
authors.initials: SM
authors.lastname: Ahmed
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland, Oregon.
authors.forename: David S H
authors.initials: DS
authors.lastname: Lee
mesh_terms: D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D015331:Cohort Studies; D017281:Cost of Illness; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D031341:Origanum; D012111:Residence Characteristics; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000458:organization & administration; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: drugs; medications; multimorbidity; older; rural