Why Where You Live Can Affect Alzheimer’s Diagnosis and Care

Alzheimer's is a terrible disease.

We’re always learning more about it and how to stop it.

The good news is that new research is shedding light on something many patients already suspect: where you live can play a big role in whether you get timely medical care.

A recent mapping study of Alzheimer’s disease and related dementias (ADRD) in Maryland found clear differences between urban and rural communities. The takeaway is simple, and concerning: access to healthcare strongly influences who gets diagnosed and treated — and who may be missed.

Urban vs. Rural Access

Maryland found clear differences between urban and rural communities. The takeaway is simple but concerning: access to healthcare strongly influences who gets diagnosed and treated, and who may be missed.

The findings were shared at the Society for Risk Analysis Annual Conference.

Across the U.S., most large hospitals are located in cities. Rural hospitals often have fewer resources, smaller staffs, and much tighter budgets.

In this study, researchers found that doctors and specialists trained in Alzheimer’s and dementia care tend to be clustered in urban areas. For people living in rural communities, that can mean longer travel times for appointments, testing, and follow-up care… something that’s especially challenging for adults over 80.

When access is limited, diagnosis is often delayed or never happens at all.

Not good.

You may not know this, but Alzheimer’s disease currently affects nearly 7 million Americans, and that number is expected to double by 2060.

Early diagnosis matters, but the study suggests many rural patients may be slipping through the cracks.

Researchers looked at data from over 422,000 Maryland patients and noticed a troubling pattern: some rural areas had high Alzheimer’s-related death rates but low diagnosis rates. This suggests that many people may be living with dementia without ever being formally diagnosed.

Urban areas, by comparison, had better access to hospitals and higher diagnosis rates.

What the Mapping Revealed

To better understand the patterns, researchers used geographic mapping tools to examine hospital access, poverty, and chronic health conditions such as diabetes and heart disease.

They identified several counties where Alzheimer’s patients appear to face the greatest barriers to care, including Garrett, Allegany, Kent, Calvert, Queen Anne’s, Talbot, St. Mary’s, and Charles counties. These areas showed signs of higher risk paired with lower access to medical services.

While this study focused on Maryland, the researchers believe similar patterns likely exist in rural communities across the country.

The message is an important one: Alzheimer’s outcomes aren’t shaped solely by biology.

Access to care, local resources, and early evaluation play a huge role. As healthcare systems continue to face staffing and funding challenges, making sure patients in rural areas aren’t left behind will be critical.

If you or a loved one has concerns about memory or cognitive changes, early evaluation,  even if it requires extra effort, can make a meaningful difference.