Read this before you make your next move.
We already know there are connections between where you live and your risk of divorce, your stress levels, and even your longevity, but new research reveals a link between brain health and your hometown.
According to a study published in the journal Alzheimer’s & Dementia, your chance of being diagnosed with dementia can vary depending on where in the U.S. you live, with older residents in some locales twice as likely to be diagnosed with the disease.
However, it’s not that the risk of developing dementia is necessarily higher in certain zip codes — it’s about the likelihood of receiving a diagnosis. “The message is clear: from place to place, the likelihood of getting your dementia diagnosed varies, and that may happen because of everything from practice norms for health care providers to individual patients’ knowledge and care-seeking behavior,” the study’s lead author Julie Bynum, MD, MPH, said in a statement.
Before you freak out (and pack up), we’re breaking down the findings and what they really mean.
What did the study find about dementia risk?
A team at the University of Michigan Medical School analyzed data on 4.8 million Medicare claims nationwide, focusing on areas with higher rates of dementia. Ideally, all patients on the same insurance plan would have equal access to care, but that’s clearly not the case.
“The findings suggest that the chance of being diagnosed may be more about the health system than about individual factors that affect dementia risk,” Dr. Bynum said in a news release.
Researchers found that people residing in areas with a low diagnosis intensity rate (predicted rate of diagnosis for new and total Alzheimer’s and dementia cases) are 28 percent less likely to get a timely diagnosis. However, in areas where physicians may be more aggressive in their level of care, people are 36 percent more likely to be diagnosed with some form of dementia.
While they looked at three age groups — 66 to 74, 75 to 84, and 85 and over — the differences between regions of the country are larger in the first group, when the brain disorder is thought to be the most treatable, and in Black and Hispanic people, who are at much higher risk for dementia.
As with any study, it had some limitations. Dr. Bynum noted that researchers couldn’t determine whether the diagnosis rate is “too high or too low” based on their data alone. “We can only say that it is higher or lower than the national average rate,” she said. She added that they would need the “actual number of people living with dementia in each community,” which she acknowledges “would be incredibly costly to measure.”
They also only looked at Medicare FFS beneficiaries and cannot necessarily be applied to those enrolled in other programs.
Additionally, the study “was not designed to determine whether the regional differences in the likelihood of ADRD diagnosis we observed led to differences in population health outcomes.”
Which parts of the U.S. have the highest rates of dementia?
If you’re particularly proactive when it comes to brain health, and you want healthcare providers who are just as on top of it, you’re probably itching to know where dementia diagnoses are most and least concentrated.
Researchers found that the Southeast — also known as the “stroke belt” — had the greatest concentration of dementia cases. This includes Miami, Florida; Lake Charles, Louisiana; Oxford, Mississippi; and Alabama (Tuscaloosa and Montgomery). However, the diagnostic intensity varied even in this region once researchers adjusted for other factors, such as alcohol consumption, lower levels of education, depression, diabetes, high blood pressure, obesity, smoking, and low social contact.
Texas — specifically McAllen, Wichita Falls, and Harlingen — also had among the highest rates in the country, along with New York (Bronx, Manhattan) and Michigan (Detroit, Dearborn, Royal Oak).
Dr. Bynum attributes these discrepancies across the country to differences in clinical practices. For instance, in some places, doctors might screen their patients more often for early signs of dementia or give them better access to specialists who can confirm a diagnosis. They could also just reflect cultural or personal differences: People in certain parts of the country may be more reluctant to seek medical care or bring up health concerns of any kind.
But there’s a silver lining: Dr. Bynum believes these areas with lower-than-expected diagnosis rates can use these latest findings to figure out what’s getting in the way: “The goal these days should be to identify people with cognitive issues earlier, yet our data show the younger age group of Medicare participants is the one with the most variation.”
