ArticleBMC geriatrics2021
Access to primary care and cognitive impairment: results from a national community study of aging Americans.
Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 40 citations in OpenAlex.
- Adaptive pathways for multimodal community-based detection of cognitive impairment: the CogScreen I study.Scientific reports · 2026Trial
- Integrated primary care for home-dwelling older adults with mild cognitive impairment in China: a hybrid effectiveness-implementation trial protocol.BMC geriatrics · 2025Trial
- Neighborhood Disadvantage and Dementia Risk Among Older Patients With Kidney Failure: Differences by Race/Ethnicity and Urbanicity.Kidney medicine · 2026Article
- Unfavorable Social Determinants of Health Are Associated with Lower Cognitive Performance in Non-Hispanic Black Men - The HABS-HD Study.Alzheimer's & dementia. Behavior & socioeconomics of aging · 2026Article
- Assessing racial disparities in dementia-related vulnerabilities: a machine learning analysis of social, environmental, and climate factors.Ethnicity & health · 2026Article
- Hearing Loss, Cognitive Decline, and Dementia: Clinical Intersections.Audiology research · 2026Review
- Social vulnerability shapes deep clinical phenotypes and brain health in aging and dementia across Latin America.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Social connection and cognitive health: A review of concepts, measures, and research priorities.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- Association Between Relative Fat Mass and Risk of Cognitive Impairment: The Role of Social Determinants of Health.Actas espanolas de psiquiatria · 2026Article
- Circulating Biomarkers of Neurodegeneration and All-Cause and Dementia-Specific Mortality.Neurology · 2026Article
- The policy exposome of dementia: Gaps, opportunities, and research agenda.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- Cumulative poverty across early adulthood and midlife cognition: findings from the national longitudinal survey of youth.Journal of epidemiology and community health · 2026Article
- Cognitive trajectories of older adults before and after the COVID-19 pandemic: socioeconomic and psychological disparities in the Lc65+ cohort.Innovation in aging · 2026Article
- Telehealth Access and Use Among Older Adults Post-COVID-19: Heterogenous Effects on Cognitive Functioning.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2025Article
- Dementia prevention requires moving beyond individual choice: the costs of effort and time intersect with social determinants of health.Neuroscience · 2025Review
- Social exposome and brain health outcomes of dementia across Latin America.Nature communications · 2025Article
- Article
- Cognitive Correlates of Resilience in Adults Experiencing Homelessness.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2025Article
- Life course socioeconomic position and cognitive aging in later life: A scoping review.Advances in life course research · 2025Article
- Health insurance coverage moderates the relationship between metabolic syndrome and baseline memory outcomes in Latino older adults.The Clinical neuropsychologist · 2025Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundDespite a growing burden of Alzheimer's Disease and related dementias (ADRD) in the US, the relationship between health care and cognitive impairment prevention is unclear. Primary care manages risk causing conditions and risk reducing behaviors for dementia, so we examine the association between individual and area-level access to primary care and cognitive impairment in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
methodsREGARDS participants with a cognitive assessment and vascular measurements at their baseline visit were included in this cross-sectional analysis. Cognitive impairment was defined as a Six-Item Screener (SIS) score < 5. Primary care supply, primary care utilization and emergency department (ED) utilization were measured at the primary care service area (PCSA) level based on participant's address. Individual access to care was self-reported. Models were adjusted for confounding by demographics, socioeconomic status and behavioral risk factors.
resultsAmong 25,563 adults, living in a PCSA with low primary care supply was associated with 25% higher odds of cognitive impairment (OR 1.25 CI 1.07-1.45). Not having a regular source of medical care was associated with 14% higher odds of cognitive impairment (OR 1.14 CI 1.02-1.28), and living in a PCSA with high emergency department utilization was associated with 12% higher odds of cognitive impairment (OR 1.12 CI 1.02-1.23).
conclusionsOur results are an important first step in understanding how health care may prevent cognitive impairment. They highlight the importance of primary care and suggest future work clarifying its role in preventing cognitive decline is imperative.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.