Cognitive aging in rural communities: preliminary memory characterization of a community cohort from Southern Nevada.

Introduction: Rural-dwelling older adults face unique health challenges that may increase risk for Alzheimer's disease and dementia but are underrepresented in aging research. Here, we present an initial characterization of a rural community cohort compared to an urban cohort from the same region. Methods: Adults over age 50 living in a non-metropolitan area are clinically characterized using the Uniform Data Set, enriched with additional measures of verbal and non-verbal memory measures. Neighborhood disadvantage is also assessed. Clinical and cognitive differences between cohorts were explored after stratifying by cognitive impairment. Results: Between group comparisons found that rural-dwellers demonstrated better verbal memory than urban-dwellers on primary indices of learning, recall, and recognition, with small to medium effects in overall comparisons. When stratified by impairment, rural-urban differences were notably larger among cognitively normal individuals. Within-group comparisons found that the magnitude of impairment between cognitively normal and impaired groups was greater among rural-dwellers compared to urban-dwellers. No differences in non-verbal memory or overall clinical status were found, and there were no effects of neighborhood disadvantage on any cognitive measure. Discussion: Living in a rural community presents a complex set of contextual factors that for some, may increase risk for dementia. In this study, we found small to moderate memory advantages for rural-dwellers, leaving open the possibility that late-life rural living may be advantageous for some and promote resilience. Additional prospective research is critically needed to better understand the factors that influence aging outcomes in this underrepresented population.