Why are people in rural and regional communities three to five times more likely to develop dementia?

What are the statistics?

Australians living in rural and remote areas are three to five times more likely to develop dementia than their city dwelling counterparts. Now, thanks to a Dementia Australia Research Foundation fellowship worth $365,000, a team from the University of South Australia led by Dr Smith will examine what causes this trend – and how to reverse it.

“We know there are 12 modifiable risk factors for dementia which include things like smoking, diet, exercise and social isolation and we have collected good data on how these risk factors impact people living in Australian cities,” Dr Smith said. 

But research into these same risk factors, and possible solutions, for rural and regionally-based Australians is limited.

“We know people living in rural and regional communities don’t want city-based solutions,” Dr Smith said.

“It’s no good telling people in regional Australia to join walking groups if there aren’t safe footpaths in their community to walk on, if there isn’t adequate lighting and other infrastructure that we take for granted in cities.”

What are they doing with the funding?

Dr Smith said the fellowship,  would enable her team to create dementia prevention strategies specifically tailored for rural and regional communities. 

“This grant will enable us to go to regional and rural areas to collect data around risk factors and identify how dementia risk factors cluster differently compared to urban communities,” she said. 

Dr Smith said the second part of the project will be to partner with the communities of Mt Gambier, Whyalla and Port Lincoln in South Australia to design targeted, culturally and geographically appropriate, and sustainable dementia prevention strategies. 

Dr Smith said the final part of the project would be the co-design of a bespoke dementia prevention toolkit for use in rural communities. 

“By co-designing the toolkit with people living in rural and regional communities, we will ensure the toolkit is acceptable and aimed at extending healthy life and delaying dementia onset in Australians who live outside major cities.” 

What is the reality of living with dementia in a regional area?

Jack was diagnosed with Alzheimer’s disease in 2021 and he and his partner Chris live in Wagait Beach, a rural town around 150 kilometres from Darwin.

The couple moved to Wagait Beach around 20 years ago and live on a 5-acre native bush block. With a population of 600 people, Wagait Beach has no local doctor and to access essential health services, Jack and Chris either login remotely via zoom or drive 150 kms to Darwin or catch the ferry across the Darwin Harbour.

Chris says often you make the decision to move to a rural or remote area when people are fit and well, but things can change and that’s when you realise the barriers between rural and city life.

"We understood the costs associated with ferry travel, the need to attend a doctor/pharmacy in Darwin, source tradespersons and other suppliers from Darwin et cetera,” she said.  

“These realities come into much greater focus after a diagnosis of dementia. There are no local medical services across the spectrum from GPs to pharmacy to allied health specialist. Therefore, timely interventions in care and the changing needs as the dementia progresses is not easily met.

“Having medical specialists required to sign off and complete forms (required for accessing services for example carer payments) is problematic and special trips to Darwin are required.”

It’s not just the distance to travel to services though, it’s also the physical challenge of getting there. The ferry across the Darwin Harbour is only accessible through one ferry provider and with a high tide change of up to eight metres, the ferry terminal is designed to be flexible, but is not suitable for anyone with a disability.

“Although Jack is mobile and can use the ferry to get to Darwin that will not be the case should he need a walker or wheelchair as our jetty is not disability compliant (no ramps, only step). Even now with some of the visuospatial issues he has to carefully negotiate the jetty," Chris said.

“There are no alternate transport options if Jack (who doesn’t drive) wanted to attend a function elsewhere without me or go to the local club. Similarly, there are no public transport services from here to Darwin via road.”

Despite the challenges however, Chris and Jack see benefit in continuing to live in a rural town.

“We had expected and still would want to live out our later years in this rural community.

“Jack feels very safe in this community, he is well known and still goes go walking alone. There are eyes everywhere. There is minimal traffic, no street lights, so there is no sensory over stimulation and less hazards.

“The big thing is familiarity with the house, the block, the neighbours and the friends. It is a close knit and supportive place to live where people have offered assistance as we need it.”

How can you help?

If you would like to get involved in research projects into dementia, you can find all studies currently recruiting participants on our website.

The Dementia Australia Research Foundation relies on financial support from generous individuals and organisations committed to investment in dementia research. If you would like to help us to support more research into dementia with projects just like this one, you can donate to dementia research here.

Want to read more about research? Check out these articles: 

Can intermittent fasting reduce the risk of developing Alzheimer’s disease? Many people have heard of, or tried, intermittent fasting to try to lose weight. But can fasting help in other ways?

What is lecanemab? Lecanemab, the new treatment for Alzheimer’s disease, has been a big news story recently and in this article, we take a closer look at what it is, if it works and what the big deal is.

How do we fit a large bed through a small door? In this article we spoke to Dr Rebecca Nisbet about the obstacles she’s overcome in her career researching the blood-brain barrier and how she is trying to fit “a large bed through a small door”.

What is it like to take part in dementia research? We spoke to Dementia Advocate Dr Ron Sinclair OAM about his vast experience contributing to research, including his advice to others that everyone has a right to be heard.

Want to read more stories like this one? Subscribe to Dementia Australia’s eNews.