Image of Eric Jutkowitz, Ph.D.

Rural Medicare beneficiaries with Alzheimer’s and related dementias have longer nursing home stays and shorter survival time than their urban peers, a new study has found. 

Among more than 550,000 Medicare beneficiaries, investigators tracked the number of days of survival after dementia diagnosis and the percent of these days per month spent in a hospital, hospice nursing home, or in the community with or without home healthcare services.

In addition to longer nursing home stays and earlier death, rural county residents were found to experience fewer hospital inpatient days than urban county residents in the six years following dementia diagnosis, and fewer days living in the community.

The further the time from diagnosis, the greater the difference in nursing home stays and community residence, added Eric Jutkowitz, Ph.D., and colleagues from the Brown University School of Public Health, Providence, RI. In contrast, each group spent a similar amount of time using home health and hospice services. 

Despite shortages of geriatricians and other geriatric specialists in rural areas, the researchers found no significant difference between the rural and urban participants in either the amount of healthcare received or satisfaction with access to care.

“Very few studies have examined trajectories of care and outcomes of older adults with an Alzheimer’s and related dementia diagnosis, and to our knowledge, none have been conducted on a national level,” the researchers noted.

The study was published Thursday in JAMA Network Open.