Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-05T08:26:38.288Z Has data issue: false hasContentIssue false

Examining Rural Older Adults’ Perceptions of Cognitive Health*

Published online by Cambridge University Press:  24 May 2017

Juanita Bacsu*
Affiliation:
Community Health and Epidemiology, University of Saskatchewan Saskatchewan Population Health and Evaluation Research Unit
Sylvia Abonyi
Affiliation:
Community Health and Epidemiology, University of Saskatchewan Saskatchewan Population Health and Evaluation Research Unit
Marc Viger
Affiliation:
Saskatchewan Population Health and Evaluation Research Unit Department of Family Medicine, University of Saskatchewan
Debra Morgan
Affiliation:
Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan
Shanthi Johnson
Affiliation:
Saskatchewan Population Health and Evaluation Research Unit Centre for Kinesiology, Health & Sport; University of Regina
Bonnie Jeffery
Affiliation:
Saskatchewan Population Health and Evaluation Research Unit Faculty of Social Work, University of Regina
*
La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Juanita Bacsu, M.A., Ph.D. Community Health and Epidemiology University of Saskatchewan Department of Community Health & Epidemiology Rm. 3247 – E wing – Health Sciences 104 Clinic Place Saskatoon, SK, S7N-2Z4 <[email protected]>

Abstract

Existing cognitive health literature focuses on the perspectives of older adults with dementia. However, little is known about the ways in which healthy older adults without dementia understand their cognitive health. In rural communities, early dementia diagnosis may be impeded by numerous factors including transportation challenges, cultural obstacles, and inadequate access to health and support services.

Based on participant observation and two waves of 42 semi-structured interviews, this study examined healthy, rural older adults’ perceptions of cognitive health. By providing an innovative theoretical foundation informed by local perspectives and culture, findings reveal a complex and multidimensional view of cognitive health. Rural older adults described four key areas of cognitive health ranging from independence to social interaction. As policy makers, community leaders, and researchers work to address the cognitive health needs of the rural aging demographic, it is essential that they listen to the perspectives of rural older adults.

Résumé:

La littérature existante sur la santé cognitive se concentre sur les perspectives des personnes âgées atteintes de démence. Cependant, on sait peu de la façon dont les personnes âgées en bonne santé, sans démence, comprendre leur santé cognitive. Dans les communautés rurales, le diagnostic précoce de la démence peut être entravé par de nombreux facteurs, y compris le défi du transport, les obstacles culturels et l’accès inadéquat aux soins de santé et aux services de soutien.

Sur la base des observations des participants et de deux séquences de 42 entrevues semi-structurées, cette étude a examiné les perceptions de la santé cognitive des personnes agées en milieu rural. En fournissant une base théorique innovante, éclairée par la culture et les perspectives locales, les résultats révèlent une vision complexe et multidimensionnelle de la santé cognitive. Il est essentiel que les décideurs, les chefs communautaires et les chercheurs, dans la mesure où ils travaillent pour répondre aux besoins de santé cognitive d’une population vieillissante en milieu rural, écoutent les opinions des personnes âgées rurales.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This work was supported by the Canadian Institutes for Health Research; the Public Health and Agricultural Rural Ecosystem (PHARE) Graduate Training Scholarship; the Saskatchewan Health Research Foundation; the Saskatchewan Population Health and Evaluation Research Unit; and the University of Saskatchewan. We thank the rural older adult participants, as well as the following community partners for their time, insight, and contributions: Noreen Johns, Grant Conlin, and Murray Westby.

Authors’ Note: A version of this article is included in a manuscript-style Ph.D. dissertation (https://ecommons.usask.ca/handle/10388/ETD-2016-04-2486).

References

Alzheimer Society of Canada. (2010). Rising tide: The impact of dementia on Canadian society. Toronto, ON: Author. Retrieved from http://www.alzheimer.ca/en/Get-involved/Raise-your-voice/Rising-Tide Google Scholar
Anderson, L., Day, K., Beard, L., Reed, P., & Wu, B. (2009). The public’s perceptions about cognitive health and Alzheimer’s disease among the U.S. population: A national review. The Gerontologist, 49(S1), S3S11.Google Scholar
Friese, S. (2013). ATLAS.ti 7 User Guide and Reference. Berlin, DEU: ATLAS.ti 7 Scientific Software Development GmbH. Retrieved from http://atlasti.com/wp-content/uploads/2014/05/atlasti_v7_manual_201312.pdf?q=/uploads/media/atlasti_v7_manual_201312.pdf Google Scholar
Averill, J. (2012). Priorities for action in a rural older adults study. Family and Community Health, 35(4), 358372.CrossRefGoogle Scholar
Averill, J. (2015). Qualitative data analysis. In De Chesney, M. (Ed.), Nursing research using data analysis: Qualitative designs and methods in nursing (pp. 110). New York, NY: Springer.Google Scholar
Bacsu, J., Jeffery, B., Abonyi, S., Johnson, S., Novik, N., Martz, D., & Oosman, S. (2014a). Healthy aging in place: Perceptions of rural older adults. Educational Gerontology, 40(5), 327337.Google Scholar
Bacsu, J., Jeffery, B., Novik, N., Abonyi, S., Oosman, S., Johnson, S., & Martz, D. (2014b). Policy, community and kin: Interventions that support rural healthy aging. Activities, Adaptation and Aging, 38(2), 138155.Google Scholar
Beard, R., Fetterman, D., Wu, B., & Bryant, L. (2009). The two voices of Alzheimer’s: Attitudes toward brain health by diagnosed individuals and support persons. The Gerontologist, 49(S1), S30S39.Google Scholar
Bergstrom, M., Holmes, M., & Pecchioni, L. (2000). Lay theories of successful aging after the death of a spouse: A network text analysis of bereavement advice. Health Communication, 12(4), 377406.CrossRefGoogle ScholarPubMed
Blackstock, K., Innes, A., Cox, S., Smith, A., & Mason, A. (2006). Living with dementia in rural and remote Scotland: Diverse experiences of people with dementia and their carers. Journal of Rural Studies, 22(2), 161176.Google Scholar
Blumhagen, D. (1980). Hyper-tension: A folk illness with a medical name. Culture, Medicine and Psychiatry, 4(3), 197224.CrossRefGoogle ScholarPubMed
Bowman, G. L., Silbert, L. C., Howieson, D., Dodge, H. H., Traber, M. G., Frei, B., … Quinn, J. F. (2012). Nutrient biomarker patterns, cognitive function and MRI measures of brain aging. Neurology, 78(4), 241249.CrossRefGoogle ScholarPubMed
Canadian Mental Health Association. (2016). Social determinants of health. Retrieved from https://ontario.cmha.ca/provincial-policy/social-determinants/ Google Scholar
Caxia, C. (2016). A review of mental health approaches for rural communities: Complexities and opportunities in the Canadian context. Canadian Journal of Community Mental Health, 35(1), 2945.Google Scholar
Centers for Disease Control and Prevention (2007). The healthy brain initiative: A national public health road map to maintaining cognitive health. Chicago, IL: Alzheimer’s Association. Retrieved from http://www.cdc.gov/aging/pdf/thehealthybraininitiative.pdf Google Scholar
Cohen, D., Manuel, D. G., & Sanmartin, C. (2016). Do rural patients in Canada underutilize preventive care for myocardial infarction? Journal of Rural Health, 32(4), 345352.Google Scholar
Connell, C., Kole, S., Avey, H., Benedict, C., & Gilman, S. (1996). Attitudes about Alzheimer’s disease and dementia service delivery network among family caregivers and service providers in rural Michigan. American Journal of Alzheimer’s Disease and Other Dementias, 11(3), 1525.CrossRefGoogle Scholar
Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
Eales, J., Keating, N., Rozanova, J., Bardick, A., Swindle, J., Bowles, R. T., … Dobbs, B. (2006). Caring contexts of rural seniors: A case study of diversity among older adults in rural communities. Phase III – Technical Report. Retrieved from Veterans Affairs Canada website: http://www.veterans.gc.ca/pdf/about-us/research-directorate/rural-seniors-technical-report-phase3.pdf Google Scholar
Fereday, J., & Muir-Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods, 5(1), 111.Google Scholar
Forbes, D., & Hawranik, P. (2012). Looming dementia care crisis: Are Canadian rural and remote settings ready? In Kulig, J., & Williams, A. (Eds.), Health in rural Canada (pp. 447461). Vancouver, BC: UBC Press.Google Scholar
Forbes, D., & Janzen, B. (2004). Comparison of rural and urban users and non-users of home care in Canada. Canadian Journal of Rural Medicine, 9(4), 227235.Google Scholar
Forbes, D., Morgan, D., & Janzen, B. (2006). Rural and urban Canadians with dementia: Use of health care services. Canadian Journal on Aging/La Revue canadienne du vieillissement, 25(3), 321330.Google Scholar
Furnham, A. (1988). Lay theories: Everyday understanding of problems in the social sciences. Oxford, ENG: Pergamon Press.Google Scholar
Gessert, C., Waring, S., Bailey-Davis, L., Conway, P., Roberts, M., & VanWormer, J. (2015). Rural definition of health: A systematic literature review. BMC Public Health, 15(2015), 378392.Google Scholar
Gibbs, G. (2007). Analyzing qualitative data. London, ENG: Sage.Google Scholar
Goins, T., Spencer, M., & Williams, K. (2011). Lay meanings of health among rural older adults in Appalachia. Journal of Rural Health, 27(1), 1320.Google Scholar
Hansen, E., Hughes, C., Routley, G., & Robinson, A. (2008). General practitioners’ experiences and understandings of diagnosing dementia: Factors impacting on early diagnosis. Social Science & Medicine, 67(11), 17761783.CrossRefGoogle ScholarPubMed
Hendrie, H. C., Albert, M. S., Butters, M. A., Gao, S., Knopman, D. S., Launer, L. J., …Wagster, M. V. (2006). The NIH cognitive and emotional health project: Report of the critical evaluation study committee. Alzheimer’s and Dementia, 2(1), 1332.Google Scholar
Hebert, L., Weuve, J., Scherr, P., & Evans, D. (2013). Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology, 80(19), 17781783.CrossRefGoogle ScholarPubMed
Hosking, D., Sargent-Cox, K., & Anstey, K. (2015). An Australian survey of cognitive health beliefs, intentions, and behaviours through the adult life course. Preventative Medicine Reports, 2(2015), 498504.CrossRefGoogle ScholarPubMed
Jacklin, K., Walker, J., & Shawande, M. (2013). The emergence of dementia as a health concern among First Nations populations in Alberta, Canada. Canadian Journal of Public Health, 104(1), 3944.Google Scholar
Jorm, A. F. (2000). Mental health literacy. Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177, 396401.Google Scholar
Keating, N. & Phillips, J. (2008). A critical ecological perspective on rural ageing. In Keating, N. (Ed.), Rural ageing. A good place to grow old? Bristol, ENG: Policy Press.Google Scholar
Kleinman, A. (1986). Social origins of distress and disease. New Haven, CT: Yale University Press.Google Scholar
Kirby, M. J. L., & LeBreton, M. (2002). Interim report on the state of the health care system in Canada. The health of Canadians – The federal role, Volume two: Current trends and future challenges. Ottawa, ON: Standing Senate Committee on Social Affairs, Science and Technology. Retrieved from http://www.parl.gc.ca/Content/SEN/Committee/371/SOCI/rep/repjan01vol2-e.pdf Google Scholar
Laditka, S. B., Corwin, S. J., Laditka, J. N., Liu, R., Tseng, W., Wu, B., … Ivey, S. L. (2009). Attitudes about aging well among a diverse group of older Americans: Implications for promoting cognitive health. The Gerontologist, 49(S1), S30S39.Google Scholar
Lanting, S., Crossley, M., Morgan, D., & Cammer, A. (2011). Aboriginal experiences of aging and dementia in a context of sociocultural change: Qualitative analysis of key informant group interviews with Aboriginal seniors. Journal of Cross Cultural Gerontology, 26(1), 103117.Google Scholar
Lautenschlager, N., Cox, K., Flicker, L., Foster, K., van Bockxmeer, F., Xiao, J., et al. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease. Journal of American Medical Association, 300(9), 10271037.CrossRefGoogle ScholarPubMed
Meuser, T., Boise, L., & Morris, J. (2004). Clinician beliefs and practices in dementia care: Implications for health educators. Educational Gerontology, 30(6), 491516.Google Scholar
Morgan, D., Semchuk, K., Stewart, N., & D’Arcy, C. (2002). Rural families caring for a relative with dementia: Barriers to use of formal services. Social Science & Medicine, 55(7), 5164.CrossRefGoogle ScholarPubMed
National Institute on Aging. (2013). Featured health topic: Memory/cognitive health. Retrieved from http://www.nia.nih.gov/health/featured/memory-cognitive-health Google Scholar
Nishida, H. (1999). A cognitive approach to intercultural communication based on schema theory. International Journal of Intercultural Relations, 23(6), 753777.Google Scholar
O’Shea, E., Walsh, K., & Scharf, T. (2012). Exploring community perceptions of the relationship between age and social exclusion in rural areas. Quality in Ageing and Older Adults, 13(1), 1626.Google Scholar
Pew Research Centre. (2014). Attitudes about aging: A global perspective. Retrieved from http://www.pewglobal.org/2014/01/30/attitudes-about-aging-a-global-perspective/ Google Scholar
Pimlott, N., Persaud, M., Drummond, N., Cohen, C., Silvius, L., Seigel, K., … Dalziel, W. (2009). Family physicians and dementia in Canada: Part 1 clinical practice guidelines: Awareness, attitudes and opinions. Canadian Family Physician, 55(5), 506507.Google Scholar
Popay, J. (2012). The knowledge needed to deliver social justice and health equity. International Journal of Qualitative Methods, 11(2), 5960.Google Scholar
Popay, J. (2006). Whose theory is it anyway? Journal of Epidemiology Community Health, 60(7), 571572.Google Scholar
Public Health Agency of Canada. (2011). What determines health? Retrieved from http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php Google Scholar
Quinn, N. (2005), Finding culture in talk: A collection of methods, New York, NY: Palgrave Macmillan.Google Scholar
Richardson, L. (2000). Evaluating ethnography. Qualitative Inquiry, 6(2), 253255.Google Scholar
Rothwell, N., Bollman, R. D., Tremblay, J., & Marshall, J. (2002). Recent migration patterns in rural and small town Canada (Agriculture and Rural Working Series Paper No. 55). Ottawa, ON: Statistics Canada. Retrieved from http://www.statcan.gc.ca/pub/21-601-m/21-601-m2002055-eng.pdf Google Scholar
Saskatchewan Ministry of Health. (2014). Covered population 2014. Regina, SK: Author. Retrieved from https://www.ehealthsask.ca/health-data/covered-population/Documents/2014-covered-population.pdf Google Scholar
Slama, K. (2004). Rural culture is a diversity issue. Minnesota Psychologist. Available from http://www.apa.org/practice/programs/rural/rural-culture.pdf Google Scholar
Smale, B., & Dupuis, S. (2004). In their own voices: A profile of dementia caregivers in Ontario. Waterloo, ON: University of Waterloo. Retrieved from www.marep.uwaterloo.ca/PDF/InTheirOwnVoices1-SurveyResults.pdf Google Scholar
Statistics Canada. (2011a). Aboriginal Peoples in Canada: First Nations People, Métis and Inuit (Catalogue no. 99-011-X2011001). Retrieved from https://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-011-x/99-011-x2011001-eng.cfm Google Scholar
Statistics Canada. (2011b). Projected population, by projection scenario, sex and age group July 1, Canada, provinces and territories, annual (CANSIM table 052-0005). Ottawa, ON: Author.Google Scholar
Statistics Canada. (2015). Canada’s population estimates: Age and sex, July 1, 2015. Retrieved from http://www.statcan.gc.ca/daily-quotidien/150929/dq150929b-eng.htm Google Scholar
Strauss, C. (2005). Analyzing discourse for cultural complexity. In Quinn, N. (Ed.), Finding culture in talk: A collection of methods. New York, NY: Palgrave Macmillan.Google Scholar
Teel, C. (2004). Rural practitioners’ experiences in dementia diagnosis and treatment. Aging and Mental Health, 8(5), 422429.Google Scholar
World Health Organization. (2002). Active aging: A policy framework. Retrieved from http://apps.who.int/iris/bitstream/10665/67215/1/WHO_NMH_NPH_02.8.pdf Google Scholar
World Health Organization & Calouste Gulbenkian Foundation. (2014). Social determinants of mental health. Geneva, CHE: World Health Organization. Retrieved from Lisbon Institute of Global Mental Health website: http://www.lisboninstitutegmh.org/assets/docs/publications/9789241506809_eng.pdf Google Scholar
World Health Organization. (2012). Dementia: A public health priority. Retrieved from http://www.who.int/mental_health/publications/dementia_report_2012/en/ Google Scholar
Wu, B., Goins, R., Laditka, J., Ignatenko, V., & Goedereis, E. (2009). Gender differences in views about cognitive health and healthy lifestyle behaviors among rural older adults. The Gerontologist, 49(S1), S72S78.Google Scholar