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Rural Health Disparities in Alzheimer’s Disease and Related Dementias Biomarker Testing
Rashelle M. Hoffman, Elise Choquette, Erin M. Blocker, Blake Murphy, Bryant Howren, Eric D. Vidoni. Innovation in Aging, 2025-12-01
Topic: Amyloid, tau and blood-test diagnosis
Abstract Early diagnosis of cognitive impairment through clinical tests and Alzheimer’s disease and related dementias (ADRD) biomarkers improves psychosocial care, reduces caregiver stress, and lowers healthcare costs. With the development of plasma biomarkers, ADRD testing has become more accessible for rural providers. However, it is unclear if rural providers have integrated these biomarkers into practice and whether barriers remain. At the 2024 Nebraska Rural Health and Vulnerable Population Conferences, 25 participants from 12 counties in Nebraska and Iowa completed a questionnaire on ADRD biomarker use and perceptions of an ADRD diagnosis. Most (64%) were patient-facing providers, while 36% were healthcare administrators. Although all providers reported regular cognitive screening in their practice, 75% were not ordering biomarker testing, with 68.75% expressing no interest. Among those using biomarkers (25%), blood plasma and PET imaging were the only methods reported. Most providers (62%) felt unqualified to order biomarkers. Across both administrators and providers, 39.1% reported that their organizations were not supportive, with 26.1% reporting only slight support for biomarker use. After a 30-minute educational session, participants showed greater positivity toward an ADRD diagnosis and increased confidence in discussing early detection. While cognitive screening is common in rural settings, there is limited use of biomarker testing, primarily due to a lack of knowledge about ADRD biomarker practices.
Key findings
- Among those using biomarkers (25%), blood plasma and PET imaging were the only methods reported.
- Most providers (62%) felt unqualified to order biomarkers.
- Across both administrators and providers, 39.1% reported that their organizations were not supportive, with 26.1% reporting only slight support for biomarker use.
- After a 30-minute educational session, participants showed greater positivity toward an ADRD diagnosis and increased confidence in discussing early detection.
- While cognitive screening is common in rural settings, there is limited use of biomarker testing, primarily due to a lack of knowledge about ADRD biomarker practices.
Why it matters
Among 25 rural providers and administrators surveyed, 75% were not ordering ADRD biomarker testing and 62% felt unqualified to order biomarkers, though a 30-minute educational session improved confidence. This describes barriers to using biomarkers in rural practice, not a treatment, cure, or prevention.
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Study details
- Participants25
- Effect size68.75%; 39.1%; 26.1%
- Evidence strengthLow
How this study scored 37/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 25 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Eric D. Vidoni: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | University of Kansas Medical Center: institution h-index 578 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 37 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Hoffman, R. M., Choquette, E., Blocker, E. M., Murphy, B., Howren, B., & Vidoni, E. D. (2025). Rural Health Disparities in Alzheimer’s Disease and Related Dementias Biomarker Testing. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.024
Vancouver
Hoffman RM, Choquette E, Blocker EM, Murphy B, Howren B, Vidoni ED. Rural Health Disparities in Alzheimer’s Disease and Related Dementias Biomarker Testing. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.024.
BibTeX
@article{hoffman2025-4d25e5d3,
author = {Hoffman, Rashelle M. and Choquette, Elise and Blocker, Erin M. and Murphy, Blake and Howren, Bryant and Vidoni, Eric D.},
title = {{Rural Health Disparities in Alzheimer’s Disease and Related Dementias Biomarker Testing}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.024},
url = {https://doi.org/10.1093/geroni/igaf122.024}
}
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