Dose-Response Association Between Psychological Distress and Risk of Completed Suicide in the General Population

Discussion | This analysis suggests that altitude of residence may impact the risk for dying of Alzheimer dementia. Ecologic studies of this type must be interpreted cautiously. Unexamined factors may account for differential reporting of cases across counties, including miscategorization of other forms of dementia. For instance, 1 high-altitude county (Alpine) reported no cases in 2005. We were not able to reliably assess many confounders, including comorbidities and air pollution. None of the sociodemographic factors we controlled for mitigated the estimated association, and the same results were found among the larger counties that had more reliable rate estimates.