2024/08/23 by Jason M. Fletcher, Katie Jajtner, Jinho Kim · 1 voice · 1 citation
Medicine · Environmental Science · #Dementia and Cognitive Impairment Research #Alzheimer's disease research and treatments #Health, Environment, Cognitive Aging
paper · doi:10.1016/j.ssmph.2024.101708
openalex publication_date 2024/08/23 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
This study investigates geographic variations in ADRD mortality in the US. By considering both state of residence and state of birth, we aim to discern the relative importance of these geospatial factors. We conducted a secondary data analysis of the National Longitudinal Mortality Study (NLMS), that has 3.5 million records from 1973 to 2011 and over 0.5 million deaths. We focused on individuals born in or before 1930, tracked in NLMS cohorts from 1979 to 2000. Employing multi-level logistic regression, with individuals nested within states of residence and/or states of birth, we assessed the role of geographical factors in ADRD mortality variation. We found that both state of birth and state of residence account for a modest portion of ADRD mortality variation. Specifically, state of residence explains 1.19% of the total variation in ADRD mortality, whereas state of birth explains only 0.6%. When combined, both state of residence and state of birth account for only 1.05% of the variation, suggesting state of residence could matter more in ADRD mortality outcomes. Findings of this study suggest that state of residence explains more variation in ADRD mortality than state of birth. These results indicate that factors in later life may present more impactful intervention points for curbing ADRD mortality. While early-life environmental exposures remain relevant, their role as primary determinants of ADRD in later life appears to be less pronounced in this study. • This study examines geographic variation in Alzheimer's Disease and Related Dementia (ADRD) mortality. • Both state of birth and state of residence accounted for a modest portion of ADRD mortality variation. • The state of residence explains more variation in ADRD mortality than the state of birth. • Targeting regional factors in later life could offer more effective intervention points to mitigate ADRD mortality.