Home › Research › Risk factors
Associations between U.S. county‐level social infrastructure and dementia among Medicare beneficiaries, 2020
Alyssa W. Goldman, Jessica Finlay, Megan Doherty Bea. Alzheimer s & Dementia Behavior & Socioeconomics of Aging, 2025-07-07
Topic: Risk, prevention and care in population studies
Higher densities of civic organizations were associated with lower county dementia incidence, while museums and recreational facilities were associated with lower prevalence and incidence. Religious organizations were associated with significantly higher rates. County urbanicity moderated the effects of recreational facilities, senior centers, libraries, and coffee shops. Types of social infrastructure may help address dementia and related needs by providing social, educational, and other cognitively-protective resources to county residents. Social infrastructure warrants further attention as an area for local investment to reduce geographic disparities in dementia.
Key findings
- Higher densities of civic organizations were associated with lower county dementia incidence, while museums and recreational facilities were associated with lower prevalence and incidence.
- Religious organizations were associated with significantly higher rates.
- County urbanicity moderated the effects of recreational facilities, senior centers, libraries, and coffee shops.
- Types of social infrastructure may help address dementia and related needs by providing social, educational, and other cognitively-protective resources to county residents.
- Social infrastructure warrants further attention as an area for local investment to reduce geographic disparities in dementia.
Why it matters
This study found that higher densities of certain types of social infrastructure, such as civic organizations and museums, were associated with lower county dementia rates, while religious organizations were associated with higher rates. These are county-level associations and do not prove that investing in social infrastructure would prevent or treat Alzheimer's disease.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Evidence strengthLow
How this study scored 32/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia Behavior & Socioeconomics of Aging) |
| Journal's citation record | 0 / 4 | Alzheimer s & Dementia Behavior & Socioeconomics of Aging: journal h-index 4 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Megan Doherty Bea: h-index 8 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Wisconsin–Madison: institution h-index 1,518 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41532087) |
| Free to read | 2 / 2 | Free to read |
| Total | 32 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/bsa3.70029
- PubMed: 41532087
- Original source →
- Free full text: Alzheimer s & Dementia Behavior & Socioeconomics of Aging →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Goldman, A. W., Finlay, J., & Bea, M. D. (2025). Associations between U.S. county‐level social infrastructure and dementia among Medicare beneficiaries, 2020. Alzheimer s & Dementia Behavior & Socioeconomics of Aging. https://doi.org/10.1002/bsa3.70029
Vancouver
Goldman AW, Finlay J, Bea MD. Associations between U.S. county‐level social infrastructure and dementia among Medicare beneficiaries, 2020. Alzheimer s & Dementia Behavior & Socioeconomics of Aging. 2025. doi:10.1002/bsa3.70029. PMID: 41532087.
BibTeX
@article{goldman2025-41532087,
author = {Goldman, Alyssa W. and Finlay, Jessica and Bea, Megan Doherty},
title = {{Associations between U.S. county‐level social infrastructure and dementia among Medicare beneficiaries, 2020}},
journal = {Alzheimer s \& Dementia Behavior \& Socioeconomics of Aging},
year = {2025},
doi = {10.1002/bsa3.70029},
pmid = {41532087},
url = {https://doi.org/10.1002/bsa3.70029}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 17.