Mapping Social Health and Dementia Risk: A Register-Based Study of Older Adults in Finland

Elisa Cisotto , Università Cattolica del Sacro Cuore
Margherita Moretti, Bocconi University
Margherita Silan, University of Padua
Joan Damiens, University of Helsinki
Pietro Belloni, University of Padua
Kaarina Korhonen, University of Helsinki
Pekka Martikainen, University of Helsinki

This study investigates the role of individual- and area-level social health factors in shaping geographic variation in dementia incidence among older adults in Finland. Using register data on all individuals born between 1935 and 1939 and residing in Finland in 2010 (N=161,909), we include several indicators of social health alongside key sociodemographic variables to estimate dementia incidence over a 10-year follow-up period. To address compositional confounding on the geographical comparison, we applied the Matching on Average Rank for Multiple Treatments (MARMoT), a matching-based method that equalizes the distribution of the key sociodemographic and social health characteristics across municipalities. We then used spatial scan statistics to detect clusters of excess dementia risk before and after this adjustment. Results show that, prior to adjustment, several contiguous clusters of elevated dementia risk emerged, particularly in eastern and southern Finland. After balancing individual-level characteristics, the spatial clustering pattern changed substantially: some clusters disappeared, suggesting they were largely driven by population composition, while others persisted or newly emerged (central-western Finland), indicating the influence of contextual or unmeasured factors and revealing hidden geographic vulnerability. Our findings highlight the relevance of social health for dementia prevention and demonstrate the importance of combining spatial and matching-based methods to disentangle compositional and contextual drivers of health inequalities. This study also offers a novel application of register-based data for studying cognitive ageing, showing that spatially targeted policies may help reduce dementia risk in ageing societies.

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 Presented in Session 31. Flash Session Family Relationships, Social Networks, Health and Wellbeing in Later Life