title: Perceived Social Determinants of Health Among Older, Rural-Dwelling Adults with Early-Stage Cognitive Impairment.
abstract: Limited access to resources and delayed detection of subtle cognitive changes may negatively impact the long-term cognitive health of rural-dwelling adults. This study explored perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment. Semi-structured interviews were conducted with older, rural-dwelling adults with early-stage cognitive impairment and their care partners. Thematic content analysis was performed. Participants ( n = 9) were 73.7 ± 6.0 years of age with 14.2 ± 3.1 years of education; care partners ( n = 10) were 70.9 ± 7.4 years of age with 15.6 ± 2.3 years of education. Data analysis revealed six themes: Staying active, Eating well, Living with cognitive changes, Living rural, Connecting with neighbors and community, and Relying on children. Dyads' depictions of perceived social determinants of health focused on the adoption of a healthy lifestyle, description of relationships, and advantages of living in a rural area. Emergent themes may be used to promote adoption of self-management and prevention behaviors, particularly lifestyle changes.
authors.affiliation: University of Pittsburgh, School of Nursing, USA.
authors.forename: Meghan K
authors.initials: MK
authors.lastname: Mattos
authors.affiliation: University of Pittsburgh, School of Nursing, Graduate School of Public Health, and Clinical and Translational Science Institute, USA.
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.affiliation: Virginia Commonwealth University, Langston Center for Quality, Safety & Innovation, School of Nursing, USA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Baernholdt
authors.affiliation: New York University, Langone Medical Center, USA.
authors.forename: Lu
authors.initials: L
authors.lastname: Hu
authors.affiliation: University of Pittsburgh, Schools of Nursing and Medicine, USA.
authors.forename: Marci L
authors.initials: ML
authors.lastname: Nilsen
authors.affiliation: University of Pittsburgh, Schools of Nursing and Medicine, Clinical and Translational Science Institute, USA.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Lingler
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D010465:Perception; D036301:Qualitative Research; D012424:Rural Population; D000073278:Self-Management; D064890:Social Determinants of Health
keywords: Alzheimer’s disease; health care disparities; mild cognitive impairment; qualitative methods; rural health