Exploring technology access, knowledge, and preferences for detection, monitoring, and support of cognitive health in rural communities

Approximately 25% of adults in the United States aged 60 years and older experience Mild Cognitive Impairment (MCI) or Subjective Cognitive Decline (SCD) which may be precursors to Alzheimers Disease. Families living in rural areas and contending with MCI/SCD face unique challenges due to geographic isolation, lack of specialty healthcare providers, and limited access to information and resources that support brain health. Thus, digital health technologies hold promise for improving cognitive health in rural communities. This study explored the access, knowledge, and preferences of rural individuals with MCI/SCD and their family members for detection, monitoring, and support of cognitive health. A convergent mixed methods design was used with semi-structured interviews informed by the Senior Technology Acceptance Model, paired with descriptive survey data from N=20 individuals with MCI/SCD and their family members. The majority of participants had access to and knowledge of technologies to support cognitive health, although preferences for detection, monitoring, and support differed between individuals with MCI/SCD and family members. Participants described aspects of technology that they valued (e.g., to organize and track tasks, to "exercise" ones brain, to communicate with healthcare providers, to promote safety of the person with MCI/SCD), as well as concerns that they had (e.g., "generational" barriers to adoption and use, financial cost, privacy and security, lack of human interaction). Findings from this study will directly inform the development of supportive technologies for meeting the needs of rural families experiencing MCI/SCD. Author SummaryRural "memory care deserts" are characterized by lack of specialty healthcare providers and lack of basic information and resources to support brain health. Although telehealth may be an option in such places, there are a variety of barriers that impede widespread implementation including lack of infrastructure and financial resources, limited high-speed internet, interstate provider and billing issues, and general mistrust among users of technology, as well as non-rural healthcare providers. Thus, digital health technologies that are inexpensive, user-friendly, sustainable, and delivered within community settings such as senior centers may hold promise for supporting brain health in rural communities. To successfully develop these technologies, however, we must have a deep understanding of the perspectives of potential users so that we may leverage what they value in technology (e.g., ability to organize and track tasks, to "exercise" the brain, to communicate with providers), as well as address the concerns that they have (e.g., cost, privacy and security, lack of human interaction). This mixed-methods study (qualitative interviews, survey data) explores these issues and provides information to directly inform development of brain health resources for rural memory care deserts.