DMV has lowest dementia rates in the U.S.

Photo by Caroline McFarland | Unsplash.com

By Christy Bieber
Posted on July 07, 2025

The risk of dementia varies surprisingly across the United States. People in certain areas, like the Southeastern states, have dementia rates as much as 25% higher than the baseline.

Researchers at the University of California, San Francisco, conducted a large-scale study of more than 1.2 million older veterans enrolled in the VA medical system from 1990 to 2021. Participants were studied for a period of 12.6 years, and dementia rates were calculated per 1,000 person-years.

The data, which was published in JAMA Neurology, revealed that the lowest rates of dementia occurred in the Mid-Atlantic region. Within this region of the country, which includes Delaware, Maryland, New Jersey, Pennsylvania, Virginia, Washington, D.C. and West Virginia, there were 11.2 cases of dementia per 1,000 person-years.

Dementia hot spots

Since our region had the lowest incidence rates, it became the baseline against which other regions were compared, revealing shocking geographic disparities. Specifically:

The Southeast region had dementia rates 25% higher than the mid-Atlantic baseline.
Both the Northwest and Rocky Mountain regions saw 23% higher rates.
Incidence rates in the South were 18% higher.
Rates were 13% higher in the Southwest.
Both the Midwest and South Atlanta had 12% higher rates.
Rates were 7% higher in the Northeast and the Great Lakes.

Researchers accounted for other factors affecting dementia risks, such as age, rates of cardiovascular disease, race and rural versus urban living, as rural areas tend to see higher rates of dementia. Even after adjusting for these factors, the regional differences persisted.

Why the stark disparities?

This study did not provide conclusive answers as to why there is such significant regional variation in dementia diagnoses. However, study authors put forth several potential theories.

“Quality of education, early life conditions and environmental exposures may be among those factors,” said Christina Dintica, Ph.D., one of the study authors.

Past research has also suggested that factors such as labor market conditions, environmental hazards, structural racism and overall adult health and mortality can make an impact.

Still other studies have shown that the difference in diagnosis rates can be largely explained by differences in health systems rather than by an actual disparity in dementia rates.

Just because more people are diagnosed in a particular location does not mean that more people have the condition. Rather, it may be that more people are likely to seek help in that region — or doctors there are more likely to identify the issue.

Reduce your dementia risk

The good news is that you can still reduce your risk of dementia. According to the Lancet Commission on Dementia Prevention, up to 45% of dementia cases are preventable.

Here are some ways the commission recommends to protect your brain and reduce your risk:

Complete your secondary education.
Address hearing loss by getting a hearing aid.
Lower your cholesterol if it is elevated.
If you have been diagnosed with depression, get treatment.
Avoid traumatic brain injury by wearing helmets, seatbelts and avoiding falls.
Aim for 75 minutes (at the very minimum) of aerobic activity per week.
Avoid type 2 diabetes or get treatment for diabetes and pre-diabetes.
Don’t smoke, or quit if you are a smoker.
Treat high blood pressure.
Maintain a healthy weight.
If you drink, do so only in moderation.
Avoid social isolation and loneliness.
Keep your eyes and vision healthy.
Reduce your exposure to air pollution by monitoring your local air quality index and limiting your outdoor activities on days with poor air quality. This is especially important if you live in areas affected by wildfires.

The real estate listing company Redfin has published property-level air quality data, so you can see your home’s overall risk. Just scroll down to the climate section and click on “air factor.”

Other studies have recommended keeping your mind active with games, puzzles, and lifelong learning.

Taking these steps is a lot easier than packing your bags and moving, and they can be one of the best options you have for keeping your mind sharp as you age.