Urbanicity, Neighborhood Conditions, and Dementia Mortality

Question How are urbanicity and neighborhood socioeconomic and environmental conditions associated with dementia mortality? Findings In this cohort of 40,948,445 individuals followed from 2011 to 2023, curvilinear inverted U-shaped associations between dementia mortality and urbanicity were found, with the highest risk at intermediate urbanicity. Neighborhood conditions attenuated most of this gradient, and modest improvements in service accessibility and outdoor living environment were associated with up to a 10.5% reduction in dementia deaths. Meaning Understanding the urbanicity gradient in dementia mortality and contributions of underlying neighborhood factors can inform targeted intervention to mitigate dementia burden and improve equity.