A secluded cottage in the quiet countryside might seem better for your brain than a home in a crowded city. But a new study of dementia mortality across England found a more surprising pattern.
Researchers at Cambridge University examined data from nearly 41 million individuals in England from 2011 to 2023. Dementia-related deaths were highest not in the most densely populated cities or the most rural areas, but in the suburbs and other mid-density neighborhoods. The researchers calculated that improving access to services and the quality of outdoor spaces in the most disadvantaged communities could prevent up to 10.5 percent of dementia deaths.
The findings highlight how our understanding of neurodegenerative disease has evolved. For decades, the search for the causes of dementia focused largely on the brain and body. Now, researchers are increasingly looking outward, examining how the places where people live—and the conditions they encounter there—can shape brain health.
In 2017, the Lancet Commission identified nine modifiable risk factors for dementia—including obesity, smoking, depression, hearing loss and social isolation. Unlike age, genetics and sex, these are factors that people or governments can potentially change. The commission added air pollution and traumatic brain injury in 2020, followed by high cholesterol and vision loss in 2024.
Together, these risk factors may help explain why dementia-related deaths were higher in medium “urbanicity” areas (calculated by population density and conditions such as income, housing, service accessibility, education and employment), according to the 2026 study.