Mild Cognitive Impairment in Rural Areas: Research Advances and Implications for Clinical Practice and Healthcare Policy.

Mild cognitive or neurocognitive impairment (MCI) may be more prevalent in rural areas. Differences between rural and urban MCI patients in terms of risk factors, course and prognosis are rarely reported. The present review aims to summarize the latest research on MCI in rural areas. A literature search was performed in the databases of PubMed, Scopus and ScienceDirect for articles published over the last decade. Eleven articles were included in this review, reporting on the differences between rural and urban MCI patients. Several risk factors, such as older age, lack of activities and food insecurity have been associated with MCI in both rural and urban areas, whereas others, such as obesity, adverse childhood experiences and plasma chemokine C-C motif ligand 11 (considered as a potential negative regulator of neurogenesis), differed according to the place of residence. No specific protective factor for rural women has been reported. There is some evidence that MCI may present earlier in rural residents, but that progression to dementia may be more rapid in urban residents. It seems that there may be clinically relevant differences in the onset, course and prognosis of MCI with regards to the place of residence (urban vs rural). Those differences should be taken into account for the design of health policies and service delivery across different settings.