Corewell Health™ and Michigan State University researchers have measured significant rates of undiagnosed mild cognitive impairment (MCI) in rural Western Michigan. Using health records of over 1.5 million patients (with all personal identities removed), the study provides unprecedented insights into the rates and risk factors of MCI across urban and rural areas.
This pioneering study, supported by the Corewell Health-MSU Alliance and the National Institutes of Health, is a significant step forward in understanding and addressing MCI diagnosis and treatment in rural communities.
Why it matters
- Undetected MCI prevents treatments that could slow or reverse cognitive decline.
- Underdiagnosing MCI could have profound consequences for healthcare delivery in rural areas.
By the numbers
- Patients progressing directly to dementia without a prior MCI diagnosis (MCI skippers) were 3 times more prevalent than those initially identified with MCI.
- The ratio of MCI skippers to diagnosed MCI cases was 4.3 times higher in rural areas compared to 2.8 times in urban areas.
- MCI incidence rates in West Michigan were significantly lower than the national average of 10% to 18%.
"Our hypothesis from the beginning of this work was that we would have underreporting of cognitive impairment in communities across West Michigan; we just didn't know to what extent. Our suspicion was initially derived from national data that reports a growing incidence rate of MCI within our aging U.S. population. Our patient data mirrors a subset of the national data; however, our patient MCI incidence rate in West Michigan is significantly lower than national averages." —David Chesla, co-principal investigator and senior director of research data management at Corewell Health Research Institute
The challenge
The study highlights the disparity in detecting and managing MCI between urban and rural areas. Limited access to healthcare leaves many rural residents vulnerable to undiagnosed cognitive decline.
A closer look
Risk factors for MCI vary between urban and rural populations. While common risk factors include diabetes, stroke, hearing loss, Parkinson's disease, and older age, urban areas exhibited additional risks:
- Being African American
- Inflammatory bowel disease
- Obstructive sleep apnea
- Insomnia
What's next
The researchers are now using their findings to develop AI tools to identify high-risk patients earlier, potentially revolutionizing MCI diagnosis and management nationwide.
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