Original ArticlesGeographic Distribution of Dementia Mortality: Elevated Mortality Rates for Black and White Americans by Place of BirthGlymour, M. Maria ScD*; Kosheleva, Anna MS*; Wadley, Virginia G. PhD†; Weiss, Christopher PhD‡; Manly, Jennifer J. PhD§Author Information *Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA †Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham School of Medicine, Birmingham, AL ‡Quantitative Methods in the Social Sciences Program, Columbia University §Gertrude H. Sergievsky Center, The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Department of Neurology, Columbia University Medical Center, New York, NY Supported in part with funding from the Harvard Program on the Global Demography of Aging, funded by the National Institute on Aging (National Institutes of Health). The authors declare no conflicts of interest. Reprints: M. Maria Glymour, ScD, Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge 617, Boston, MA 02115 (e-mail: firstname.lastname@example.org). Received June 14, 2010 Accepted November 19, 2010 Alzheimer Disease & Associated Disorders: July-September 2011 - Volume 25 - Issue 3 - p 196-202 doi: 10.1097/WAD.0b013e31820905e7 Buy Metrics Abstract We hypothesized that patterns of elevated stroke mortality among those born in the United States Stroke Belt (SB) states also prevailed for mortality related to all-cause dementia or Alzheimer Disease. Cause-specific mortality (contributing cause of death, including underlying cause cases) rates in 2000 for United States-born African Americans and whites aged 65 to 89 years were calculated by linking national mortality records with population data based on race, sex, age, and birth state or state of residence in 2000. Birth in a SB state (NC, SC, GA, TN, AR, MS, or AL) was cross-classified against SB residence at the 2000 Census. Compared with those who were not born in the SB, odds of all-cause dementia mortality were significantly elevated by 29% for African Americans and 19% for whites born in the SB. These patterns prevailed among individuals who no longer lived in the SB at death. Patterns were similar for Alzheimer Disease-related mortality. Some non-SB states were also associated with significant elevations in dementia-related mortality. Dementia mortality rates follow geographic patterns similar to stroke mortality, with elevated rates among those born in the SB. This suggests important roles for geographically patterned childhood exposures in establishing cognitive reserve. © 2011 Lippincott Williams & Wilkins, Inc.