Published July 20, 2026

Farming is one of the nation’s most dangerous occupations. Add dementia or memory loss to the equation, and the risk of serious injury becomes even greater, according to a new University of Iowa study.

The study, led by Kanika Arora, associate professor in the Department of Health Management and Policy in the University of Iowa College of Public Health, found that older adults with dementia who experienced farm-related injuries were more likely to suffer severe injuries and require intensive care or surgery than older adults with dementia who were injured outside farm settings.

“The higher severity in the former compared with the latter likely reflects differences in injury mechanisms between the two groups,” Arora said. “Falls caused 94% of traumatic injuries in individuals with dementia alone but accounted for only 35% of injuries in those with both agricultural injuries and dementia. Non-fall mechanisms on the farm may be inherently more severe.”

Compared with nonfarming older adults with dementia, older farmers with dementia experienced a broader range of injury causes, including motor vehicle incidents and environmental hazards.

As people age, changes in memory and decision-making can make everyday farm work especially hazardous, particularly when operating farm vehicles or machinery, handling hazardous materials, or working alone. Farm work also is physically demanding.

“Unlike other sectors, farming lacks a defined retirement age,” Arora said. “Nearly 40% of producers are 65 or older—up 12% since 2017.”

The study, published in the American Journal of Industrial Medicine, analyzed hospital data from more than 700 U.S. trauma centers from 2017 to 2021 and compared older adults with agricultural injuries, dementia, or both.

Researchers found that injury severity was similar among older adults with agricultural injuries, regardless of whether they had dementia.

Arora said these findings suggest that older adults with dementia who experience agricultural injuries remain involved in farm activities that are just as hazardous as those performed by people without dementia.

Fewer older adults had both agricultural injuries and dementia, which may reflect underdiagnosis in rural areas or lower participation in agricultural work among people with dementia.

Co-authors of the study, “Agricultural Injuries With Dementia: Double Whammy?,” are Jonathan Davis, assistant professor of occupational and environmental health at the College of Public Health; Lila Basnet, graduate research assistant of health management and policy at the College of Public Health; and Julie Bobitt, assistant professor in the Center for Dissemination and Implementation Science at the University of Illinois Chicago.

Dementia in rural America

An estimated 7 million Americans ages 65 and older were living with dementia in 2025. Symptoms include impaired judgment, visual-spatial difficulties, and balance issues.

Arora said long-term exposure to agriculture is associated with a 46% greater likelihood of developing Alzheimer’s disease and related dementias, possibly because of factors such as pesticide exposure and midlife hearing loss from noisy machinery.

“Early-life farm residence has also been linked to lower cognitive function in later life,” she said.

A dementia safety program for farm families

Most dementia safety programs, Arora said, focus on residential settings while overlooking farm environments that include hazards such as livestock, heavy equipment, and unsecured firearms.

“They also fail to reflect the lived realities of farming communities, where work is deeply tied to identity and purpose and full retirement is relatively uncommon,” she said. “Consequently, standard dementia safety recommendations—such as removing access to tractors or ceasing work—can feel intrusive or impractical, leading to low adherence.”

Arora and her colleague Julie Bobitt developed Farm Families Coping With Dementia (FFCD) with support from the National Institute for Occupational Safety and Health (NIOSH).

FFCD is a free, four-week educational series for caregivers and family members of people showing signs of dementia who live on farms or in agricultural settings. Topics include dementia basics, farm safety, caregiving, and communication.

Learn more about and register for Farm Families Coping With Dementia.

Some resources

Helping farm families manage dementia care (College of Public Health)

Arora discusses the impact of dementia on farm families (Iowa Public Radio)