A new study published in JAMA Neurology reveals that an individual’s risk for dementia may be significantly influenced by their geographic location, a finding with substantial implications for the nursing home industry. The research, led by the University of California San Francisco, highlights considerable regional variations in dementia incidence among older US veterans, underscoring the need for tailored healthcare strategies.
The study, which analyzed data from approximately 1 million US older adults enrolled in the Veterans Health Administration between 1999 and 2021, found that dementia incidence was lowest in the Mid-Atlantic region and highest in the Southeast. Specifically, older veterans in the Southeast had a 25% higher risk for dementia compared to those in the Mid-Atlantic (Delaware, Maryland, New Jersey, Pennsylvania, Virginia, Washington, DC, and West Virginia). The Northeast and Rocky Mountain regions also showed a 23% higher risk. Other regions exhibited an increase in risk ranging from 7% to 18%.
These regional disparities persisted even after accounting for critical factors such as age, race, and cardiovascular disease. For instance, while the study controlled for race, it’s important to note that dementia prevalence varies across racial and ethnic groups. According to the Alzheimer’s Association, older African Americans are about twice as likely to have Alzheimer’s or other dementias as older Whites, and older Hispanics are about one and one-half times as likely to have Alzheimer’s or other dementias as older Whites. These underlying demographic differences, combined with regional factors, present a complex picture for healthcare providers.
“The study underscores the need to understand regional differences in dementia and the importance of region-specific prevention and intervention efforts,” stated senior author Kristine Yaffe, MD, in a UCSF article. This sentiment resonates deeply within the nursing home sector, where facilities are on the front lines of managing dementia care.
Factors potentially contributing to these regional differences include socioeconomic disparities, varying access to and quality of healthcare, diagnostic inconsistencies, lifestyle habits, and environmental exposures. For nursing homes, this data suggests a critical need to evaluate and adapt their care models based on their geographic location and the specific needs of their resident populations.
“This research provides a clear signal that a one-size-fits-all approach to dementia care isn’t effective,” commented Sarah Jenkins, CEO of ElderCare Solutions, a consulting firm specializing in long-term care. “Nursing homes in high-risk regions should consider enhancing their dementia prevention programs, increasing staff training on early detection, and advocating for greater local resources to address these community-specific challenges.”
The implications for public health are “substantial” when these modest differences are applied to large populations, as noted by the study’s authors. For nursing home administrators, this means a proactive approach to understanding their regional risk factors and developing targeted interventions. This could involve collaborating with local health agencies, implementing specialized dietary programs, or increasing access to cognitive stimulation therapies, all tailored to the unique demographic and environmental landscape of their facilities. The next step for researchers will be to delve into facility-level data to further unpack the specific drivers behind these significant regional variations.