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WHERE CARE FALLS SHORT: MAPPING THE SUPPLY–DEMAND GAP IN ADRD CARE ACROSS AN AGING UNITED STATES
Yung Chun, Oejin Shin, Soobin Park, Sojung Park. Innovation in Aging, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract The growing prevalence of Alzheimer’s disease and related dementias (ADRD) poses urgent challenges for equitable access to long-term care across the United States. While demand for ADRD care is driven by an aging population and rising cognitive health needs, the availability of facilities and specialized services remains uneven, raising concerns about geographic disparities. This study integrates multiple data sources to evaluate the spatial balance of ADRD demand and care infrastructure at the county level. Demand is estimated using American Community Survey data on older adults with cognitive difficulties, while supply is drawn from National Care Planning Council records covering nine facility types across 31 states. Explanatory Spatial Data Analysis (ESDA) is applied to map demand, supply, and their balance, with results further disaggregated by facility type. Preliminary findings reveal sharp disparities: demand is concentrated in large metropolitan counties, the Sunbelt, and parts of the Midwest and Appalachia. Facilities cluster along the East Coast, California, Florida, and selected Midwestern metros, while deficits are greatest in the rural South, Great Plains, and Mountain West. Specialized services such as adult day programs and Alzheimer’s centers are heavily urban, whereas generalized services—nursing homes, assisted living, and retirement facilities—are more dispersed but still unevenly distributed. These findings highlight a persistent spatial mismatch between population needs and care infrastructure. The concentration of specialized services in metropolitan centers risks leaving rural and micropolitan communities underserved. Addressing these inequities is critical to promoting equitable aging, reducing caregiver burdens, and ensuring timely access to ADRD care.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Chun, Y., Shin, O., Park, S., & Park, S. (2025). WHERE CARE FALLS SHORT: MAPPING THE SUPPLY–DEMAND GAP IN ADRD CARE ACROSS AN AGING UNITED STATES. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.4048
Vancouver
Chun Y, Shin O, Park S, Park S. WHERE CARE FALLS SHORT: MAPPING THE SUPPLY–DEMAND GAP IN ADRD CARE ACROSS AN AGING UNITED STATES. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.4048.
BibTeX
@article{chun2025-8c30559a,
author = {Chun, Yung and Shin, Oejin and Park, Soobin and Park, Sojung},
title = {{WHERE CARE FALLS SHORT: MAPPING THE SUPPLY–DEMAND GAP IN ADRD CARE ACROSS AN AGING UNITED STATES}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.4048},
url = {https://doi.org/10.1093/geroni/igaf122.4048}
}
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Key findings
- Explanatory Spatial Data Analysis (ESDA) is applied to map demand, supply, and their balance, with results further disaggregated by facility type.
- These findings highlight a persistent spatial mismatch between population needs and care infrastructure.
Why it matters
This mapping study found that areas with the most older adults needing dementia care often have the fewest care facilities, especially in the rural South, Great Plains, and Mountain West. Specialized services like adult day programs and Alzheimer's centers were mostly located in cities.
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Study details
- Evidence strengthLow
How this study scored 30/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people 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 | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× 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 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Sojung Park: h-index 22 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 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 | 30 / 100 | — |
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