Each person has different reasons for choosing to live where they do. Some prefer the extra space the suburbs can afford, while others love the excitement and convenience of being in a big city. But a new study has found that where you live can also affect how likely you are to develop Alzheimer’s disease later in life. Read on to see which area’s residents are at the highest risk.
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People who live in rural areas are more likely to develop Alzheimer’s disease than urban residents.
According to a study presented at the Alzheimer’s Association International Conference, a team of researchers set out to better understand how geography factored into Alzheimer’s disease-related deaths. Using data from the National Center for Health Statistics, they were able to look at trends in Alzheimer’s mortality between 1999 and 2019 and connect them to urbanization levels.
During the two-decade span, the team found that the Alzheimer’s death rate in the overall population rose drastically from 16 to 30 deaths per 100,000, representing an 88 percent increase. But the results also found that deaths were not evenly spread out across the U.S., with rural areas posting higher mortality rates from Alzheimer’s compared to urban areas.
Results showed that the East South Central states had the highest Alzheimer’s mortality rates in the U.S.
The results were also able to pinpoint the areas of the U.S. that were hit hardest by Alzheimer’s-related deaths. The East South Central region—which includes Alabama, Kentucky, Mississippi, and Tennessee—saw the highest rate at 274 per 100,000 in those 65 years and older. This rate is more than triple that of urban areas in the mid-Atlantic region, in which mortality rates were found to be the lowest.
“Our work shows that there is an increasing discrepancy in Alzheimer’s mortality between urban and rural areas. This discrepancy could be related to, or might be the result of, other urban-rural health disparities, including access to primary care and other health services, socio-economic level, time to diagnosis, and the rising proportion of older Americans living in these areas,” Ambar Kulshreshtha, MD, the study’s author from Emory University, said in a statement. “Identifying and understanding the reasons for these health disparities is critical for allocating key social and public health resources appropriately.”
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Dementia cases are expected to triple in the next three decades, researchers say.
While the discrepancies in Alzheimer’s death rates between rural and urban areas were surprising, the overall report also made another shocking realization. A team of researchers examined data from the Global Burden of Disease (GBD) study collected between 1999 and 2019 to estimate that the number of global dementia cases will likely fall between 130.8 and 175.6 million globally within the next three decades. Averaging the figures sets a forecast of around 152.8 million dementia cases by 2050, tripling the 57 million global cases that are currently seen.
“These estimates will allow policymakers and decision-makers to better understand the expected increases in the number of individuals with dementia as well as the drivers of these increases in a given geographical setting,” Emma Nichols, the study’s lead researcher from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine, said in a statement. “The large anticipated increase in the number of individuals with dementia emphasizes the vital need for research focused on the discovery of disease-modifying treatments and effective, low-cost interventions for the prevention or delay of dementia onset.”
Other studies have found a relationship between rural residency and higher Alzheimer’s rates.
A previous study published in The American Journal of Preventive Medicine in 2017 also found a connection between rural areas and a higher rate of Alzheimer’s disease or dementia. To test their theory, researchers analyzed data from more than 16,000 adults aged 55 and older who were given medical evaluations in 2000 and 2010, WebMD reports.
Results found that dementia rates in rural areas were seven percent compared to 5.4 percent in urban areas in 2000. And while rates for both groups had dropped by 2010, rural areas still saw five percent of their population affected by the degenerative disease compared with 4.4 percent in urban areas.
“Rural communities are aging more rapidly than urban communities,” Regina Shih, PhD, the senior investigator from the nonprofit Rand Corporation that commissioned the study, said in a statement. “Given that those communities experience more health care and long-term care system challenges, we hope this research sheds light on the need to intervene on the factors that place rural seniors at greater risk for dementia.”
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