Urban-rural differences in a memory disorders clinical population

OBJECTIVES: To compare patient characteristics and family perceptions of pa tient function at one urban and one rural memory disorders clinic. DESIGN: Secondary, cross-sectional data analyses of an extant clinical data base. SETTING/PARTICIPANTS: First time visits (n = 956) at two memory disorders c linics. MEASUREMENTS: Patient and family-member demographics and assessment results for the Mini-Mental State Examination (MMSE), instrumental activities of d aily living (IADLs), activities of daily living IADLs), the Memory Change a nd Personality Change components of the Blessed Dementia Rating Scale, and the Revised Memory and Behavior Problems Checklist. RESULTS: In both. clinics, patients and family members were more likely fem ale. The typical urban clinic patient was significantly more likely to be l iving in a facility and more educated than the typical rural patient. Urban and rural patients did not show significant differences in age- and educat ion-adjusted MMSE scores or raw ADL/IADL ratings, but the urban family memb ers reported more memory problems, twice as many personality changes, more- frequent behavior problems, and more adverse reactions to problems. CONCLUSION: Physicians who practice in both urban and rural areas can antic ipate differences between patients, and their families, who seek a diagnosi s of memory disorders. Our most important finding is that despite similarit ies in reported functional abilities, urban families appear to be more sens itive to and more distressed by patients' cognitive and behavioral symptoms than rural families. These differences may reflect different underlying ne eds, and should be explored in further research.