JMIR Publications

ABSTRACT

Background:

The health and economic burdens of Alzheimer’s disease and related dementias (ADRD) are exacerbated for people living in rural social contexts who experience geographic barriers to care. There are currently few resources specifically designed to support socio-culturally diverse rural ADRD care dyads, including early detection of potential precursors to ADRD such as Mild Cognitive Impairment (MCI) and Subjective Cognitive Decline (SCD).

Objective:

The primary objective of the Northern Arizona Memory Study (NAZMS) is to develop culturally-informed and scalable resources to identify and support rural families at risk for ADRD. The purpose of this study is to introduce the NAZMS protocol and discuss its role in addressing dementia risk and promoting cognitive health in rural communities.

Methods:

This dyadic study uses a mixed-methods, digital health approach. A sample of rural care dyads with MCI or SCD is screened and recruited through partnerships with community centers across Northern Arizona. Consenting dyads complete semi-structured interviews where they answer questions about technology preferences for monitoring symptoms and engaging in remotely-delivered interventions. Next, care dyads complete separate baseline questionnaires assessing dyadic (e.g., experiences with caregiving/care-receiving) and health factors. Participants with cognitive impairment then complete a 14-day mobile protocol of brief end-of-day surveys and cognitive assessments delivered via study-provided smartphones.

Results:

Data from the qualitative interviews provide dyad preferences for intervention development. Data from the quantitative protocol specify for whom (i.e., between-person) and on which days (i.e., within-person) modifiable factors are related to better cognitive health in everyday life.

Conclusions:

This study takes a mixed-methods, digital health approach to supporting rural families at risk for ADRD by understanding intervention preferences and identifying the modifiable protective and risk factors that influence cognitive health in everyday life. The findings will directly support rural Arizonans and respond to national priorities in ADRD research for the development of community-based disease education programs and use of digital assessments of cognitive health and well-being. Clinical Trial: Not Applicable.