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Survey measures knowledge of Alzheimer’s disease in rural areas

A new measure designed to assess knowledge of Alzheimer’s disease in rural, underserved populations, known as the Basic Knowledge of Alzheimer's Disease Survey, showed utility in a study published in Aging & Mental Health.

"We must provide culturally effective Alzheimer's disease education to correct misconceptions, decrease stigma and bring awareness to the need for routine cognitive screening in populations at risk," Lisa Kirk Wiese, PhD, RN, assistant professor in Florida Atlantic University's College of Nursing and co-developer of the survey, said in a press release.

Wiese, along with other researchers from Florida Atlantic University, developed the Basic Knowledge of Alzheimer's Disease (BKAD) survey, which consists of 32 items to evaluate Alzheimer’s disease knowledge based on topics related to symptoms, risk factors, screening, prevention, treatment and care, according to the press release.

“There was no Alzheimer’s disease knowledge measure available that was appropriate for rural and other underserved populations with lower levels of health literacy and education, and which also contained the most recent information regarding Alzheimer’s disease,” Wiese told Healio Psychiatry. “This measure provides the opportunity to determine knowledge gaps and design education programs based on knowledge gaps.”

The investigators tested the BKAD survey among 228 older adults from senior centers in rural communities in southcentral Florida (the Glades) and Appalachian Virginia, West Virginia, Alabama and North Carolina. They also administered Borson’s Mini-Cog to determine participants’ risk for cognitive impairment and the Rapid Estimate of Adult Literacy in Medicine, Short Form (REALM-SF) to determine participants’ health literacy.

The researchers found that more Florida Glades residents than Appalachian residents wanted to participate in memory screening (99% vs. 62%) and saw providers routinely (94% vs. 88%); however, about the same number of residents reported prior memory screening (22% vs. 25%).

When evaluating Alzheimer’s disease knowledge gaps, they found that those with higher education and BKAD scores were more aware of risk factors, symptoms and treatment than they were of treatment and detection.

Wiese and colleagues observed that 90% of participants knew that getting help for Alzheimer’s disease sooner improved the chance to “slow it down” and around 80% knew that keeping active physically, socially and mentally may help to delay Alzheimer’s disease onset.

“During our study, regardless of the previous beliefs/stigma that persons do not want to know about Alzheimer’s disease, many older adults (88%) did want to know if they are at risk, and 73% would want to be screened,” Wiese said. “If people are aware of the benefits of early detection, then we have found that they are more willing to participate in memory screening. We also found that it is not just rural residents, but providers as well, that are unaware of recent updates regarding risk and detection of Alzheimer’s disease.”

However, less than 70% answered correctly to the question “Nothing can be done to reduce the risk of Alzheimer’s disease” and 61% answered correctly to “Persons with a history of diabetes, high blood pressure or stroke are at greater risk of Alzheimer’s disease,” according to the results. About one-third answered incorrectly that sudden vision changes may indicate risk for Alzheimer’s disease. The results showed that there were also gaps in awareness related to Alzheimer’s disease symptoms.

“We need to follow the CMS Medicare/Medicaid guidelines and conduct memory screenings annually for persons over age 65. However, many providers are not engaging in this recommendation,” Wiese said. “Many providers are also not aware that the National Institute of Aging provides online education modules, algorithms and guidelines for providers to follow throughout the entire disease management spectrum. Empowering one person to age-in-place for an additional year due to earlier intervention (rather than care through institutionalization) can save approximately $33,000.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.